Effects of a bout of exercise on mood in people with depression with and without physical pain.

Physical and mental health symptoms can reduce participation in physical activity. The current study assessed the impact of a bout of exercise on mood state in depressed participants with and without current physical pain. We enrolled a community sample of 147 participants (Mage = 45.5; SD = 11.98; 87.1% female) with elevated depressive symptoms. Individuals rated their mood state, completed a 1-mile walk test on a treadmill, and rated their mood state again. Pairwise comparisons between pre- and post-exercise mood ratings were statistically significant (p < .001) and showed improved mood state. People with at least moderate pain showed greater decreases in sadness and irritability from pre- to post- exercise bout. A single bout of exercise was associated with decreased sadness, anxiety, and irritability, and increased energy in a sample of adults with depression. The changes in sadness and irritability were greatest in those who reported at least moderate physical pain.

Is moving from targeted culling to BCG-vaccination of badgers (Meles meles) associated with an unacceptable increased incidence of cattle herd tuberculosis in the Republic of Ireland? A practical non-inferiority wildlife intervention study in the Republic of Ireland (2011-2017).

Bovine tuberculosis (BTB) remains as a costly disease of cattle-herds in the Republic of Ireland (ROI). This persistence is partially attributable to the presence of M. bovis infection in a wildlife reservoir, the European badger (Meles meles). Thus, both area-wide and limited-area targeted-badger-culling have been part of the ROI-BTB control/eradication program to help reduce the future incidence of a cattle-herd BTB breakdown (i.e. a "new herd-level occurrence of BTB"). However, neither badger-culling practice can be sustained as a major component in the ongoing BTB eradication program in the ROI. Vaccination of badgers with Bacille Calmette-Guérin (BCG) has been proposed as an alternative to badger culling. Thus, in 2011, a five-year non-inferiority study was implemented in seven counties in the ROI. This study was designed to compare and contrast the cattle-herd-BTB-incidence in areas where intramuscular badger vaccination would be implemented versus the cattle-herd-BTB-incidence in the remaining area of the same county where targeted-badger-culling was maintained as the standard treatment response to probable badger-sourced BTB breakdowns. Our outcome of interest was a new cattle-herd-BTB-episode (breakdown) with a total of >2 standard skin-test (SICTT) reactors detected during the episode. Treatments (badger vaccination or targeted badger culling) were cluster allocated based on where the majority of the herd owner's land was located. To assess the impact of the two treatments, we compared the incidence-risk, of our defined outcome, for cattle herds in the area under vaccination to the outcome incidence-risk for cattle herds in the remainder of the same county after 4 and 5 years of having implemented badger vaccination. A random-effects logit model with adjustment for clustering by treatment, and statistical control of herd-type, herd-size and five-year prior-BTB-episode history was used for our analyses. Although not included in the logistic model, a relative badger density metric based on the annual number of badgers captured-per-sett-night of capturing effort was developed for each treatment area; this metric indicated that relative badger density was approximately 40 % higher in vaccination areas than in the targeted badger-culling areas during our study. Overall, our study results indicated that vaccination was not inferior to targeted badger-culling in four counties and badger vaccination was deemed to produce ambivalent results in one (County Cork North) of the seven study sites in the ROI. A post-study investigation, in County Galway, where vaccination was deemed inferior to target culling, revealed that widespread purchases of cattle from a nearby cattle mart, by herd owners in the vaccination-area, was associated with the increased herd and vaccination-area risk of BTB. No single "biasing hypothesis" was evident for the apparent vaccine inferiority in the second study site (County Monaghan) where vaccination was deemed inferior to targeted culling; hence no further investigations were conducted.

Quantification of Mycobacterium bovis transmission in a badger vaccine field trial.

In the UK and Ireland, Bacille Calmette-Guérin (BCG) vaccination of badgers has been suggested as one of a number of strategies to control or even eradicate Mycobacterium bovis infection in badgers. In this manuscript, we present the results of a badger field trial conducted in Ireland and discuss how the novel trial design and analytical methods allowed the effects of vaccination on protection against infection and, more importantly, on transmission to be estimated. The trial area was divided into three zones North to South (A, B and C) where vaccination coverages of 0, 50 and 100%, respectively, were applied. Badgers were trapped over a 4year period. Badgers were assigned to either placebo or vaccine treatment, with treatment allocation occurring randomly in zone B. Blood samples were collected at each capture, and serology was performed in these samples using a chemiluminescent multiplex ELISA system (Enfer test). The analysis aimed to compare new infections occurring in non-infected non-vaccinated badgers to those in non-infected vaccinated ones, while accounting for the zone in which the badger was trapped and the infection pressure to which this individual badger was exposed. In total, 440 records on subsequent trappings of individual non-infected badgers were available for analysis. Over the study period, 55 new infections occurred in non-vaccinated (out of 239=23.0%) and 40 in vaccinated (out of 201=19.9%) badgers. A Generalized Linear Model (GLM) with a cloglog link function was used for analysis. Statistical analysis showed that susceptibility to natural exposure with M. bovis was reduced in vaccinated compared to placebo treated badgers: vaccine efficacy for susceptibility, VES, was 59% (95% CI=6.5%-82%). However, a complete lack of effect from BCG vaccination on the infectivity of vaccinated badgers was observed, i.e. vaccine efficacy for infectiousness (VEI) was 0%. Further, the basic reproduction ratio as a function of vaccination coverage (p) (i.e. R(p)) was estimated. Given that the prevalence of M. bovis infection in badgers in endemic areas in Ireland is approximately 18%, we estimated the reproduction ratio in the unvaccinated population as R(0)=1.22. Because VES was now known, the reproduction ratio for a fully vaccinated population was estimated as R(1)=0.50. These results imply that with vaccination coverage in badgers exceeding 30%, eradication of M. bovis in badgers in Ireland is feasible, provided that the current control measures also remain in place.

A systematic review examining factors predicting favourable outcome in cognitive behavioural interventions for psychosis.

Psychosis is a debilitating mental health condition affecting approximately 4 persons per 1000. Cognitive behavioural therapy for psychosis (CBTp) has been shown to be an effective treatment for psychosis and is recommended by several national guidelines. CBTp does not work equally well with everyone, however, with some 50% of clients receiving little benefit. This review sets out to systematically assess the literature and methodological quality of a number of studies, which examine factors predicting successful outcome in CBTp. The databases CINAHL, Cochrane, EBSCO, EMBASE, ISI Web of Science, MEDLINE (Ovid), PsycARTICLES, PsycINFO, PubMed, and Scopus were electronically searched. English language articles in peer reviewed journals were reviewed. Search terms "psychosis", "psychotic disorder", "cognitive behavioural therapy", "cognitive therapy", "randomised controlled trial", "predictor", and "treatment outcome" in various combinations were used as needed. Only randomised controlled trials (RCTs) were included. Results suggest that female gender, older age, and higher clinical insight at baseline, each predicted better outcome in CBT interventions with psychotic patients, as did a shorter duration of the illness, and higher educational attainment. Several other factors, such as higher symptom severity at baseline, were suggestive of predictive capacity but further research to clarify was indicated. Providers of mental healthcare should consider these findings when offering CBTp. The onus is also on healthcare providers to better equip non-responders to CBTp. Further investigation into a limited number of predictive factors, with an agreed set of outcome measures, would allow future researchers more direct comparisons between studies.

Adhesion of Pseudomonas fluorescens biofilms to glass, stainless steel and cellulose.

OBJECTIVES: The adhesion of colloidal probes of stainless steel, glass and cellulose to Pseudomonas fluorescens biofilms was examined using atomic force microscopy (AFM) to allow comparisons between surfaces to which biofilms might adhere. RESULTS: Biofilm was grown on a stainless steel substrate and covered most of the surface after 96 h. AFM approach and retraction curves were obtained when the biofilm was immersed in a tryptone/soy medium. On approach, all the colloidal probes experienced a long non-contact phase more than 100 nm in length, possibly due to the steric repulsion by extracellular polymers from the biofilm and hydrophobic effects. Retraction data showed that the adhesion varied from position to position on the biofilm. The mean value of adhesion of glass to the biofilm (48 ± 7 nN) was the greatest, followed by stainless steel (30 ± 7 nN) and cellulose (7.8 ± 0.4 nN). CONCLUSION: The method allows understanding of adhesion between the three materials and biofilm, and development of a better strategy to remove the biofilm from these surfaces relevant to different industrial applications.

Spatial and temporal analyses of metrics of tuberculosis infection in badgers (Meles meles) from the Republic of Ireland: Trends in apparent prevalence.

Badgers are a wildlife host of Mycobacterium bovis, the causative agent of bovine tuberculosis (bTB), and an important contributor to the epidemiology of bTB in cattle in Ireland and Britain. Repeated culling of badgers in high prevalence cattle bTB areas has been used in the Republic of Ireland as one tool to reduce intra- and interspecific transmission of M. bovis. We assessed factors that influenced infection prevalence of culled badgers from 2009 to 2012 (n=4948) where spatial, temporal and intrinsic factor data were available using multivariable modelling. Prevalence appeared higher in western areas than eastern areas of Ireland and badgers were more likely to be test-positive if caught at a sett (burrow system) which was close to other infected setts (spatial clustering of infection). There was a significant positive association between badger test-status and cattle prevalence of M. bovis infection at a spatial scale of 1km around setts. Badgers were more likely to be deemed test positive if they were male (OR: 1.9) or a parous female (OR: 1.7), compared to a female who had never conceived. Our results are consistent with different groups within badger populations having differential exposures and therefore infection risk (for example, parous vs. non-parous females). Furthermore, bTB clusters within the badger population, with greater risk to badgers in setts that are closest to other infected setts. The effective scale of the association of bTB risk between badger and cattle populations may be relatively large in Ireland. Our data indicate that the overall trend in prevalence of M. bovis infection in badgers has decreased in Ireland (P<0.001) while controlling for significant confounders over the study period, and follows a longer temporal trend from 2007 to 2013, where unadjusted apparent prevalence declined from 26% to 11% during 2007 to mid-2011, followed by a stable trend between 9 and 11% thereafter (n=10,267).

Prevalence and causes of vision loss in Southeast Asia and Oceania: 1990-2010.

BACKGROUND: To assess prevalence and causes of vision impairment in Southeast Asia and Oceania in 1990 and 2010. METHODS: Based on a systematic review of medical literature, prevalence of moderate and severe vision impairment (MSVI; presenting visual acuity <6/18 but ≥3/60 in the better eye) and blindness (presenting visual acuity <3/60) was estimated for 1990 and 2010. RESULTS: In Oceania, the age-standardised prevalence of blindness and MSVI did not decrease significantly (1.3% to 0.8% and 6.6% to 5.1%) respectively, but in Southeast Asia, blindness decreased significantly from 1.4% to 0.8%, a 43% decrease. There were significantly more women blind (2.18 million) compared with men (1.28 million) in the Southeast Asian population in 2010, but no significant gender differences in MSVI in either subregion. Cataract was the most frequent cause of blindness in Southeast Asia and Oceania in 1990 and 2010. Uncorrected refractive error, followed by cataract, macular degeneration, glaucoma and diabetic retinopathy were the most common causes for MSVI in 1990 and 2010. With the increasing size of the older population, there have been relatively small increases in the number of blind (2%), and with MSVI (14%) in Southeast Asia, whereas increases have been greater in Oceania of 14% for blindness and of 31% for MSVI. CONCLUSIONS: The prevalence of blindness has reduced significantly from 1990 to 2010, with moderate but non-significant lowering of MSVI. Cataract and uncorrected refractive error are the main causes of vision impairment and blindness; cataract continues as the main cause of blindness, but at lower proportions.

HRG-1 enhances cancer cell invasive potential and couples glucose metabolism to cytosolic/extracellular pH gradient regulation by the vacuolar-H(+) ATPase.

Haeme-responsive gene (HRG)-1 encodes a 16-kDa transmembrane protein that is induced by insulin-like growth factor-1 (IGF-1) and associates with the vacuolar-(H(+)) ATPase (V-ATPase). We previously reported that HRG-1 is essential for V-ATPase activity in endosomal acidification and receptor trafficking. Here, we show that in highly invasive and migratory cancer cell lines, HRG-1 and the V-ATPase are co-expressed at the plasma membrane, whereas in less invasive cell lines and non-transformed cells HRG-1 over-expression remains confined to intracellular compartments. Stable suppression of HRG-1 in invasive breast cancer MDA-MB-231 cells decreases extracellular pH, cell growth, migration and invasion. Ectopic expression of HRG-1 in non-invasive MCF-7 cells enhances V-ATPase activity, lowers the extracellular pH and increases the pH-dependent activity of MMP2 and MMP9 matrix metalloproteinases. HRG-1 enhances trafficking of the glucose transporter-1 (GLUT-1) with a concomitant increase in glucose uptake and lactate production. HRG-1 also promotes trafficking of the insulin-like growth factor I receptor (IGF-1R), ß1-integrin and IGF-1 signalling. Taken together, our findings indicate that HRG-1 expression at the plasma membrane enhances V-ATPase activity, drives glycolytic flux and facilitates cancer cell growth, migration and invasion. Thus, HRG-1 may represent a novel target for selectively disrupting V-ATPase activity and the metastatic potential of cancer cells.

Risk of bovine tuberculosis for cattle sold out from herds during 2005 in Ireland.

A retrospective cohort study was conducted to determine the risk of bovine tuberculosis (TB) among animals sold out from herds that were free to trade animals during the year 2005 according to their bovine TB testing history during the year 2005. The present study sample comprised of 338,960 animals, of which 124,360 animals were sold out from herds that were restricted from trading at some stage during 2005 (bovine TB 'exposed') and 214,600 animals that were sold from herds which did not have their trading status withdrawn in 2005 (bovine TB 'non-exposed'). The overall risk of a diagnosis of bovine TB during the two-year period after the animals were sold out was 0.69 per cent. The odds of bovine TB were 1.91 higher for animals sold out from bovine TB 'exposed' herds compared with animals sold out from bovine TB 'non-exposed' herds (OR 95 per cent CI: 1.76 to 2.07, P<0.0001). Ten per cent of animals identified during field surveillance with bovine TB did so less than two months after being sold out in 2005, and similarly, 10 per cent of the animals classified as bovine TB positive by finding a bovine TB lesion at slaughter did so within 25 days (or less) of being sold out in 2005.

Predictors of the first between-herd animal movement for cattle born in 2002 in Ireland.

Movement of animals between farms represents a potential risk of bovine tuberculosis (BTB) and other disease transmission. The objectives of this study were to identify and quantify risk factors associated with the first between-herd movement of animals (denoted as risk move). A random sample of 1 percent of Irish calf births registered for 2002 (20,182 animals) was selected. Descriptive and survival analysis on movement over the period 2002-2005 was performed. A total of 12,119 (60%) of animals experienced a risk move over the 4-year study period. Among those that moved, 57% did so within the first 12 months of age. For animals in dairy herds, an early peak in risk move events was observed within the first 12 weeks of age; whereas in animals from suckler herds, a later risk move peak was observed between 21 and 36 weeks of age. The survival models identified a number of risk factors: two that appeared most important in predicting a risk move were gender and enterprise type. Males had a hazard ratio of 2.6 times that of females. The hazards for enterprise type, varied over time, thus a time-varying covariate (ent_type×ln(time)) was included in the Cox model. At 7 days of age, females in suckler herds were at 0.14 times the hazard of females in dairy herds for risk move, and over time, the hazards converged, equalised by day 140, and then diverged, so that by 4 years of age, females in suckler herds were at 4.64 times the hazard of females in dairy herds. Herds with a history of selling animals in previous years maintained that record during the study period with increased hazard of risk move. Enterprise type interacted with gender so that relative to females, males from dairy herds were at greater hazard of risk move than males from suckler herds. Hazard of risk move was also a function of ln (herd area), so that each doubling of farm area was accompanied by a 30.6% decrease in the hazards. The main conclusion was that risk of movement related disease transmission also depends on the purpose of the movement whether for breeding or for beef finishing. While males were at greater hazard of movement than females, they would have a shorter lifespan, thus limiting the opportunity for further transmission post-movement.

Phosphorus budget in the low-income, peri-urban area of Kibera in Nairobi (Kenya).

Kibera, located in Nairobi, Kenya is one of the largest (235,000 inhabitants) low-income areas in East Africa. Surface waters in Kibera show high pollution levels with respect to SRP (soluble reactive phosphorus; range: 2-10 mg P/L), coming from the uncontrolled wastewater discharges in the area. The different P production and consumption values in Kibera were estimated using interviews (155 interviewed) as well as detailed P house-keeping for five representative families. The results show that highest P consumption comes from food, in particular cereals. Highest P production came from urine (55% of the total) and faeces (31%), with relatively lower contributions from grey water and solid wastes. The overall P budget in Kibera amounted to around 9 x 10(3) kg P/month. This is equivalent to 0.47 g P/person yr, both for P production and consumption, with a relative error of 20%. Comparing with the estimated P outflows via the Kibera surface waters, around 65% of the P produced in Kibera will leave the area. In future ECOSAN techniques such as urine separation could well be applied for efficient recycling of these waste sources.

The risk of a positive test for bovine tuberculosis in cattle purchased from herds with and without a recent history of bovine tuberculosis in Ireland.

A retrospective cohort study was conducted to assess if cattle sold from Irish dairy herds within 7 months of herd de-restriction (clearance to trade) from a bovine-tuberculosis (BTB) episode had an excess risk of testing positive for BTB during the following 2 years, and to determine other risk factors associated with this outcome. If possible, a predictive metric for herds at high risk of selling future BTB-positive cattle would be generated. The unexposed cohort included all cattle sold within 7 months of the annual herd test in a random sample of dairy herds that did not test positive for BTB in 2003. The exposed cohort consisted of all cattle sold within 7 months of the date of de-restriction in all dairy herds that cleared a BTB episode in 2003. Only cattle sold from herds that were initially found to test positive for BTB using the single intradermal comparative tuberculin test (SICTT)-and not due to discovery of a BTB-positive animal at slaughter-were included as exposed cattle. To aid in the development of a predictive metric, the exposed cohort was subcategorized based on the number of reactors to the SICTT in the herd of origin during the BTB episode immediately prior to sale. The final exposure categories of 0 (unexposed), 1-7, and >or=8 total reactors were considered the unexposed, mildly exposed, and severely exposed cohorts, respectively. A multivariable logistic regression model was fit to the final BTB status of the animal using a generalized estimating equation method (GEE), assuming an exchangeable correlation structure of animals within herds, and using robust standard errors. Exposure level and the other available herd- and animal-level information were modeled. After controlling for other risk factors including the size of the herd of origin and the sex and age of the animal, the three-level exposure variable significantly improved the model (based on a change in Quasi-Akaike Information Criteria of 2.2) and demonstrated a trend of increasing risk of a future positive BTB test with increasing exposure category. The severely exposed cohort of animals had significantly higher risk of a future positive BTB test than the unexposed cohort (OR=1.78, p=0.030).

Correlations between carbene and carbenium stability: ab initio calculations on substituted phenylcarbenes, nonbenzenoid arylcarbenes, heteroatom-substituted carbenes, and the corresponding carbocations and hydrogenation products.

Calculations were completed at the G3MP2 level on a large group of carbon- and heteroatom-substituted carbenes (X-CH, singlets and triplets), carbenium ions (X-CH2(+)), and their hydrogen addition products (X-CH3). One series includes 11 meta- and 12 para-substituted phenylcarbenes, X = Ar. Gas-phase enthalpies of reaction were calculated for four processes: singlet-triplet enthalpy gaps of the carbenes, DeltaH(ST); enthalpies for deprotonation of the cations yielding singlet carbenes, DeltaH(ACID); hydride ion affinities of the carbenium ions, HIA; and enthalpies of hydrogenation of the singlet carbenes, DeltaH(HYDROG). A plot of HIA vs DeltaH(HYDROG) values provides a direct comparison of substituent effects on the stabilities of the singlet carbenes and the corresponding benzylic cations. These effects are larger for the cations but are remarkably consistent over a wide range of reactivity: 166 kcal/mol in HIA. All four processes were analyzed according to the relative importance of polarizability, polar, and resonance effects. Polar and resonance effects are large and of similar magnitude for meta compounds. For the para compounds resonance effects are more dominant. Calculations were made on three nonbenzenoid arylcarbenes: Ar = cycloheptatrienyl(+), cyclopentadienyl(-), and cyclopropenyl(+). The cyclopentadienyl(-)-substituted system fits the HIA vs DeltaH(HYDROG) correlation, but the other two fall well off the line, suggesting markedly different interactions are at play. A set of heteroatom-substituted carbenes and carbocations was also examined. Points for these groups lie well above the correlation line for the HIA vs DeltaH(HYDROG) plot defined by the aryl compounds, confirming that heteroatoms stabilize the singlet carbene proportionally more than the carbocation.

Trachoma in the Pacific Islands: evidence from Trachoma Rapid Assessment.

AIMS: To establish the presence or absence of trachoma in the Pacific Island region. METHODS: Trachoma Rapid Assessment methodology was used in Kiribati, Nauru, Vanuatu, Solomon Islands and Fiji. Advised by key informants, high-risk communities were chosen from each country. All available children aged 1-9 years and adults > or = 40 years were examined. RESULTS: A total of 903 adults > or = 40 years and 3102 children aged 1-9 years were screened at 67 sites. Rates of active trachoma in children were >15% in all sites in Kiribati and >20% in all sites in Nauru. However, there was a high variability of rates of active trachoma in survey sites in Vanuatu, Solomon Islands and Fiji with rates ranging from 0% to 43% (average 23.3%), 6.0% to 51.9% (average 30.5%) and 0% to 48.8% (average 22.1%) respectively. Average rates of scarring trachoma in adults were 61.9% in Kiribati, 12.5% in Nauru, 38.2% in Vanuatu, 67.0% in the Solomon Islands and 18.8% in Fiji. Rates of trichiasis and trichiasis surgeries suggest the possibility of blinding trachoma in the region. CONCLUSION: The findings indicate that trachoma is present in all the Pacific Island countries screened. Further prevalence studies are required, and trachoma control measures should be considered.

Targeted badger removal and the subsequent risk of bovine tuberculosis in cattle herds in county Laois, Ireland.

We investigated the impact of targeted removal of badgers on the subsequent bovine tuberculosis (BTB) risk in cattle herds in county Laois, Ireland. The study period was 1989-2005. For each of 122 targeted badger-removal licenses (permit to remove badgers in the proximity of cattle herds undergoing a serious BTB episode), the herd number (index herd) for which the license was given was obtained. The herds in the proximity of the index herd were identified from another database. The main "exposure" in our study was the geographical location of herds relative to the area in which targeted badger removal was conducted. We categorized herds into five different exposure groups: herds were classified as non-exposed and denoted as group 0 (reference group) if they were located 500 m or more from the edge of any parcel of land of the index herd; group 1, was the index herds, group 2 the immediate (contiguous) neighbors of the index herd, group 3 herds were not immediate neighbors but within 150 m and group 4 herds were between 150 m and 500 m distance from the edge of any parcel of land of the index herd, respectively. We conducted a survival analysis (allowing multiple failures per herd) to compare the hazard of having a BTB episode in any of the four groups of exposed herds vs. the hazard in herds in the reference group. We controlled for other known risk factors as well taking into account a temporal component. Our analysis showed that the hazard ratio for the index herds (group 1) were non-significantly increased, indicating that there was no difference in the hazard of failing a BTB test (after the targeted badger removal was conducted) between index herds and reference herds. For the rest of the herds farther away from badger removal activities the hazards were lower than herds in areas not under badger removal. The hazard in the reference group decreased over the study period.

Survival and dispersal of a defined cohort of Irish cattle.

An understanding of livestock movement is critical to effective disease prevention, control and prediction. However, livestock movement in Ireland has not yet been quantified. This study has sought to define the survival and dispersal of a defined cohort of cattle born in Co. Kerry during 2000. The cohort was observed for a maximum of four years, from January 1, 2000 to December 31, 2004. Beef and dairy animals moved an average 1.31 and 0.83 times, respectively. At study end, 18.8% of the beef animals remained alive on Irish farms, including 6.7% at the farm-of-birth, compared with 48.6% and 27.7% for dairy animals respectively. Beef animals werae dispersed to all Irish counties, but mainly to Cork, Limerick, Tipperary and Galway. Dairy animals mainly moved to Cork, Limerick, and Tipperary, with less animals going to Galway, Meath and Kilkenny. The four-year survival probability was 0.07 (male beef animals), 0.25 (male dairy), 0.38 (female beef), and 0.72 (female dairy). Although there was considerable dispersal, the number of moves per animal was less than expected.

Risk factors for disclosure of additional tuberculous cattle in attested-clear herds that had one animal with a confirmed lesion of tuberculosis at slaughter during 2003 in Ireland.

All the Irish cattle herds considered "clear" of bovine tuberculosis (BTB) having a single animal with a tuberculous lesion at slaughter during 2003 were identified. We performed a descriptive and logistic regression analysis to investigate whether selected risk factors had an association with the result of the herd test immediately after the tuberculous lesion was found ("Factory Lesion Test", FLT). At the FLT, only 19.7% (n=338) of these 1713 herds had 1 or more standard reactors. The lesioned animal was home-bred in 46% of the "source" herds; these herds had an increased risk (23.4%) of having at least 1 standard reactor animal relative to herds with a purchased-lesioned animal (16.6%) (RR=1.41). Our logistic models identified a number of important risk factors; two that appeared most important in predicting the FLT outcome were the time spent (residency) by the lesioned animal in the "source" herd, and the presence, or not, of the lesioned animal in a previous BTB episode in either the "source" herd, or the seller's herd in the case the lesioned animal was purchased. Our models fit the data well based on the Hosmer-Lemeshow test, however their sensitivity and specificity were very low (57% and 61% respectively). Surveillance of the cattle population for BTB using lesions found at slaughter is an essential component of an overall control program. Nonetheless, due to the poor predictability of the variables we measured, complete herd investigations are needed to help explain the FLT outcome of a herd.

Predicting the need for low vision rehabilitation services.

AIMS: To determine the independent predictors of rehabilitation needs for people with low vision using the Impact of Vision Impairment questionnaire (IVI) to measure the quality-of-life consequences of vision-specific restrictions on participation in activities of daily living. METHODS: Patients attending low vision clinics completed the IVI and provided personal and clinical information such as co-morbidities and visual acuity. Rasch analysis was used to generate person measures for the IVI total and three domain scores. Rehabilitation needs were based on "mild", "moderate" or "severe" levels of restriction in participation as determined by the lower, moderate and higher tertiles of persons measures. Logistic regression analyses were used to determine independent predictors of rehabilitation needs. RESULTS: 477 patients (56% women) with a mean age 72 years (SD 15.3) were recruited. Most (74%) had moderate or severe vision loss (presenting visual acuity (VA)<6/18), and 43% had age-related macular degeneration (AMD). Females, shorter duration of vision impairment, having AMD, worse VA, a greater impact of co-morbidities on daily living and reliance on family or friends were univariately associated with poorer IVI scores (p<0.05). In all regression models, VA, the impact of comorbidities on daily living and dependence on family/friends emerged as the three strongest independent predictors of rehabilitation needs. CONCLUSION: In addition to vision, clinicians also need to consider issues relating to dependency when assessing rehabilitation needs. A more holistic approach to patient referral and rehabilitation provision is therefore warranted.

Quantification of the relative efficiency of factory surveillance in the disclosure of tuberculosis lesions in attested Irish cattle.

In Ireland, factory surveillance of cattle for gross lesions is an important supplementary method for detecting herds infected with bovine tuberculosis (tb), and in recent years between 27 and 46 per cent of all new herd breakdowns in any year have been detected by this method. The aim of this study was to determine the relative efficiency of factories in detecting lesions among attested cattle slaughtered during 2003 and 2004. National databases were available on animal slaughter, programmes of tuberculin testing for bovine tb and laboratory confirmation of suspected lesions. Factories were ranked according to their submission risk (number of animals submitted with lesions/number of attested animals killed) and confirmation risk (number of animals with laboratory-confirmed lesions/number of animals submitted with lesions), adjusting for the risk profile of the animals slaughtered, including potential confounding factors such as their age and sex, whether they were purchased or homebred, the test history of their herd, the prevalence of bovine tb in the area and the season of slaughter. Approximately 3.7 million cattle were slaughtered in 42 Irish export-licensed factories during the two years. Complete data were available for 2,374,987 animals from 84,510 attested herds in 2845 District Electoral Divisions. Samples from 7398 animals with suspected tb lesions were submitted for laboratory examination; 4767 (64.4 per cent) were positive, 2011 were negative and 620 were inconclusive. The average unadjusted submission risk for all the factories was 22 per 10,000, ranging from 0 to 58 per 10,000. The unadjusted factory confirmation risk (excluding factories that had sent in fewer than 10 lesions) varied between 34.3 per cent and 86.3 per cent. The unadjusted and adjusted submission and confirmation risks were highly correlated, and animal-related factors (including their characteristics and origin) therefore did not contribute to the variations in factory-level submission and confirmation risks.

Self-management programs for adults with low vision: needs and challenges.

OBJECTIVE: To explore the needs of individuals with low vision in order to inform the contents of a low vision self-management (SM) program and determine potential barriers to participation. METHODS: Semi-structured interviews were conducted with 48 participants with low vision resulting different from eye conditions. Qualitative analysis was conducted in order to identify major themes. RESULTS: All participants described a range of consequences as a result of vision loss including difficulties with functional activities, social interaction and emotional distress. Less than half were interested in attending a SM program. Barriers included practical reasons as well as a perceived lack of need and unclear or negative perceptions of such a program. CONCLUSION: SM programs for low vision are a promising way to help address the range of difficulties experienced by this population if barriers to participation can be overcome. PRACTICE IMPLICATIONS: SM programs should include vision-specific strategies, training in generic problem-solving and goal setting skills and how to cope with emotional reactions to vision impairment. Programs should be delivered and promoted in such a way to enhance access and encourage uptake by those with a range of vision loss in the community.