An Assessment of the Epidemiology and Herd-Level Impact of the Fractured Humerus Epidemic in New Zealand Dairy Cattle, 2007-2015: Results from Four Studies.

A multi-method approach integrating data from four independent sources was used to describe some key features of the epidemiology and estimate the herd and within-herd incidence of fractured humeri in New Zealand dairy cattle for the period 2007-2015. The first dataset was from a national case series where cases of humeral fractures in dairy cattle were identified by veterinarians across New Zealand between the 2007/2008 and 2011/2012 lactation seasons. The second dataset was from a pet food company based in the Waikato region, which collated the number of casualty first- and second-lactation cows found to have a fractured humerus post-slaughter in the 2014/2015 lactation season, and the third dataset was a case series conducted by veterinarians employed in a Waikato veterinary business, also from the 2014/2015 lactation season. For the final dataset, 505 randomly selected New Zealand dairy farmers completed a phone survey on the incidence of non-responsive, non-weight-bearing forelimb lameness in first- and second-lactation cows in the 2014/2015 lactation season. Using the telephone survey results, the within-herd and herd-level incidence of cases for first- and second-lactation dairy animals was calculated. The national case series reported 149 cases of humeral fractures in 22 dairy herds; the pet food case series identified 61 cases from 41 farms; and the practice-based case series found 14 cases from 10 farms. Humeral fractures exclusively affected first- and second-lactation dairy cows and had a peak incidence between calving and early mating. The national telephone survey found that non-weight-bearing forelimb lameness requiring euthanasia of first- or second-lactation cows occurred in 11.7% of herds, with a mean within-herd incidence of 2.6% for first lactation cows and 2.8% for second-lactation cows for affected herds. These combined datasets demonstrate that humeral fractures in young, lactating dairy cattle are more common than previously suspected and that they occur nationally and over multiple years on some farms. Further work on this condition is urgently required in New Zealand to establish cost-effective management practices that will reduce unnecessary animal suffering and waste.

An exploratory qualitative enquiry into workers' experiences of leptospirosis and post-leptospirosis in Aotearoa New Zealand.

AIMS: This pilot study describes the experiences of six people who reported post-leptospirosis symptoms. Our aim was to perform an exploratory qualitative study to document participants' experiences and to identify themes to gain understanding of the impact and burden experienced. METHODS: Participants self-recruited, meaning they had directly contacted the first author prior to the study commencing and had offered to tell their stories. Face-to-face semi-structured interviews were conducted in January 2016 and summative content analysis was used to distil themes. RESULTS: The participants were male, had been employed in livestock slaughter plants (n=2) or farming (n=4) when they first contracted leptospirosis and claimed they had been suffering from post-leptospirosis symptoms for 1-35 years. Symptoms included exhaustion, brain fog and mood swings, and participants' lifestyles and relationships were severely affected. Participants and their partners reported poor awareness and knowledge of leptospirosis when they sought help, and that employers and the Accident Compensation Corporation (ACC) were dismissive of post-leptospirosis symptoms. Participants also reported some positive experiences and had advice to share. CONCLUSION: Leptospirosis may have severe long-term consequences for patients, their families and their communities. We recommend that the aetiology, pathogenesis and burden of the persistence of leptospirosis symptoms become topics for future research.

Using a Card Sort Technique to Determine the Perceptions of First-Year Veterinary Students on Veterinary Professionalism Attributes Important to Future Success in Clinical Practice.

First-year veterinary students' perceptions on the veterinary professionalism attributes important to future success in clinical practice were explored using a card sort technique. The key findings were that self-oriented attributes (overall mean: 3.20; 42% responses were essential) and people-oriented attributes (overall mean: 3.13; 39% essential) were rated more highly than task-oriented attributes (overall mean: 2.98; 31% essential) (1-4 scale: 1 = irrelevant, 4 = essential). Within these overall ratings, the establishment/maintenance of effective client relationships (people-oriented attribute; mean: 3.84) and the ability to be composed under pressure and recover quickly (self-oriented attribute; mean: 3.82) received the highest scores. The highest task-oriented score was the ability to work to a high standard and achieve results (mean: 3.57). There was no difference between ethnicities or between men and women, but respondents < 20 years of age gave higher scores to people-oriented attributes than did older respondents (≥ 20 years). The use of the card sort technique has not been widely reported in veterinary educational literature, and so this study represents a novel approach to garnering opinions from newly enrolled veterinary students-a group of stakeholders whose views on this subject are seldom sought. The results show that first-year veterinary students have well-developed opinions on the key attributes of veterinary professionalism and indicate that the early development of students' opinions needs to be taken into consideration in the design of professionalism curricula within veterinary programs.

Using the critical incident technique to determine veterinary professional competencies important for enhancing the veterinarian-client interaction.

BACKGROUND: While previous research has examined components of professionalism that veterinary employers and clients expect in veterinarians, little attention has been paid to practising clinical veterinarians' opinions on important professional competencies that help to enhance the veterinarian-client relationship. This study used a phenomenological approach and critical incident technique to gather the narratives of practising veterinarians in New Zealand about positive and negative veterinarian-client interactions. The intention was to identify the underlying principles of professionalism that resulted in the positive/negative outcomes of those interactions. METHODS: Twenty-two practising veterinarians were interviewed, and each respondent was asked to recollect and narrate a significant positive and a significant negative critical incident in their career that involved a veterinarian-client interaction within a clinical setting. The professional competencies that the veterinarian believed contributed to a successful or an unsuccessful outcome were elucidated using thematic analysis. RESULTS: Thematic analysis of the critical incident narratives revealed four major themes under the overarching theme of 'building a relationship between the veterinarian and the client': 'accountability and integrity', 'effective communication skills', 'personal wellbeing' and 'quality of care'. CONCLUSION: The description of the important professional competencies that helped to enhance the veterinarian-client relationship provides a reference for the practising profession to help improve the likelihood of veterinarians enjoying satisfied and successful careers.

Building Veterinarians beyond Veterinary School: Challenges and Opportunities for Continuing Professional Development in Veterinary Medicine.

Continuing professional development (CPD) is an important mechanism for veterinarians to acquire, maintain, and enhance their capability to perform competently in their chosen practice area over their career. Although most licensing bodies require veterinarians to complete a minimum number of CPD hours each registration cycle, there are known issues with verifying that these activities are having the desired effects of ensuring professional competence and improving outcomes for patients, owners, and veterinarians. In this review, we summarize the literature across different health care professions to highlight three key challenges for veterinary CPD programs. These are (a) defining what it means to be professionally competent across different career stages from graduation to retirement, (b) delivering CPD activities that are effective in promoting evidence-based medicine and behavioral change in practice, and (c) developing reliable and sustainable systems to formally assess the continued professional competence of veterinarians. A common theme across all challenges was the importance of interacting with colleagues as an opportunity to receive external feedback on their professional strengths and weaknesses and to develop stronger support networks for managing common stressors in clinical practice. There was also a recognized need to develop more transparent outlines of the available and acceptable options for managing different animal health concerns as a first step toward identifying new opportunities for the veterinary profession to elevate the level of care provided. Based on these findings, we propose a new framework for defining, delivering, and evaluating CPD that promotes stronger collaboration between veterinarians to improve professional and personal well-being.

Modelling the economics of bovine viral diarrhoea virus control in pastoral dairy and beef cattle herds.

Bovine viral diarrhoea virus (BVDV) is a prevalent pathogen in the New Zealand cattle industries, yet few studies to date have evaluated the economics of BVDV in pastoral dairy and beef herds to help inform management decisions. To address this knowledge gap, we developed stochastic individual-based simulation models to represent the transmission dynamics of BVDV in typical spring-calving dairy and beef farms in New Zealand. The models conservatively estimated the direct losses due to a BVDV outbreak at NZ$ 22.22 and NZ$ 41.19 per mixed-age cow per year for a naïve dairy and beef farm, respectively, over a 5-year period. The greatest economic impacts for the dairy farm occurred when persistently infected replacement heifers joined the lactating cow group and caused transient infection of cows to drop in milk production, whereas the greatest impacts for the beef farm was through the loss of fattening stock for sale due to lowered pregnancy rates. Various combinations of diagnostic testing, vaccination, and biosecurity measures were then explored to evaluate the cost-efficiency of different strategies for controlling BVDV at the farm-level. Providing farmers with the estimates of economic impacts of BVDV in their herds may further encourage the uptake of control measures, but close collaboration with a veterinarian to determine the optimal strategy for their unique farm circumstances is still required.

Estimation of the within-herd transmission rates of bovine viral diarrhoea virus in extensively grazed beef cattle herds.

Many research groups have developed mathematical models to simulate the dynamics of BVDV infections in cattle herds. However, most models use estimates for within-herd BVDV transmission rates that are either based on expert opinion or adapted from other dairy herd simulation models presented in the literature. There is currently little information on the transmission rates for BVDV in extensively grazed beef herds partly due to the logistical challenges in obtaining longitudinal data of individual animal's seroconversion, and it may not be appropriate to apply the same transmission rates from intensive dairy herds given the significant differences in herd demographics and management. To address this knowledge gap, we measured BVDV antibody levels in 15 replacement heifers in each of 75 New Zealand beef breeding farms after their first calving and again at pregnancy scanning or weaning to check for seroconversion. Among these, data from 9 farms were used to infer the within-herd BVDV transmission rate with an approximate Bayesian computation method. The most probable within-herd BVDV transmission rate was estimated as 0.11 per persistently infected (PI) animal per day with a 95% highest posterior density interval between 0.03 and 0.34. This suggests that BVDV transmission in extensively grazed beef herds is generally slower than in dairy herds where the transmission rate has been estimated at 0.50 per PI animal per day and therefore may not be sufficient to ensure that all susceptible breeding females gain adequate immunity to the virus before the risk period of early pregnancy for generating new PI calves.

Characteristics of Endurance Competitions and Risk Factors for Elimination in New Zealand during Six Seasons of Competition (2010/11-2015/16).

The welfare of horses in endurance competitions has been the focus of recent media attention. Epidemiological studies have examined the sport at the international (FEI) level. However, much of the participation in the sport occurs at a national level in preparation for FEI level competition. The aims of this study were to describe participation in, and risk factors for elimination, from New Zealand endurance competitions. Data were collated from all endurance competitions (≥40 km) held in New Zealand during the 2010/11-2015/16 competition seasons. There were 6885 starts (n = 775 horses, n = 665 riders), horses had a median age of 9 years (IQR 6.2-10.0) and had a median of 3 (IQR 2-5) starts per season. Accumulated ride distance per season per horse decreased from a median of 240 km/horse (IQR 120-440) in 2010/11 to 180 km/horse (IQR 80-320) in 2015/16. Ride entries were dominated by the 40 km (n = 2834, 41%) and 80 km (n = 2517, 37%) distances. Eliminations increased with ride distance, from 7% in 40 km rides to 53% in the 160 km rides. Lameness accounted for the majority of eliminations (64%). The odds of elimination due to lameness were significantly associated with ride distance, location (North or South island) and time of year. The 11% of starters eliminated for metabolic reasons of the horse had increased odds of elimination associated with horse age, ride distance, location and time of year.

Epidemiological investigation of Leptospira spp. in a dairy farming enterprise after the occurrence of three human leptospirosis cases.

An epidemiological investigation was conducted in an unvaccinated dairy farming enterprise in which three workers on one of the milking herds (Herd 1) were diagnosed with leptospirosis due to serovars Hardjo (H) (n = 2) and Pomona (P) (n = 1) between January and March 2015. Blood and urine samples were collected from milking cows in Herd 1 (N = 230) and Herd 2 (N = 400), rising one- (R1, N = 125) and rising two-year-old (R2, N = 130) replacement heifers, and four pigs associated with Herd 1, in March 2015. Sera were tested using the MAT for serovars H, P, Copenhageni (C), Ballum (B) and Tarassovi (T), and urine samples were tested by qPCR. Seventy-five per cent of 109 cows in Herd 1 and 36% of 121 in Herd 2 were seropositive (≥48), predominantly to H and P, and 23% of 74 cows in Herd 1 and 1% of 90 cows in Herd 2 were qPCR positive. Fifty-five per cent of 42 R2 heifers were seropositive to T. No R1 and 17% of 42 R2 heifers were qPCR positive. Subsequently, all cattle were vaccinated for H and P, and Herds 1 and 2 were given amoxicillin. After the booster vaccination, 7% of 91 in Herd 1, 2% of 82 in Herd 2 and 11% of 38 R1 heifers (sampled as R2) were PCR positive. After the amoxicillin treatment, no cows in Herd 1 and 5% of 62 cows in Herd 2 were urine PCR positive. Calves and pigs were seropositive to H, P, C and B. Vaccination and antibiotic treatment appeared effective in reducing the risk of exposure of workers to vaccine serovars. However, evidence of non-vaccine serovars indicated that workers likely remain at risk of exposure to Leptospira.

Using Bayesian network modelling to untangle farm management risk factors for bovine viral diarrhoea virus infection.

Understanding risk factors for bovine viral diarrhoea (BVD) transmission is important for planning national disease control programmes. However, traditional statistical approaches may miss important features of BVD epidemiology due to the highly correlated nature of many farm-level risk factors. In this cross-sectional study, we used data collected from 304 cattle herds in New Zealand during 2015/2016 to compare the results from multivariable logistic regression with Bayesian network (BN) analysis. Blood samples from 15 heifers from each farm were pooled and analysed with an antibody ELISA test to classify BVD virus exposure status. Farmers were surveyed about their general management practices, knowledge about BVD, and risk factors for disease transmission, including onto- and off-farm movements, within- and between-farm contacts, and whether they implemented BVD control measures for their service bulls. Multiple imputation was used to infer missing values in the dataset prior to statistical analysis. The results showed that 57/116 (49.1%) beef farms and 95/188 (50.5%) dairy farms were likely to be actively infected with BVD virus. Almost 60% of farms had movements of heifers/cows onto the premises and 13.8% of farmers reported contact with cattle from other farms. The results of the multivariable logistic regression showed that farms where heifers/cows had been moved onto the premises during all or most of the past five years were at higher risk of being BVD seropositive than farms without those movements (OR 2.21, 95% CI 1.29-4.24). Farms where cattle had occasional or rare contacts with cattle on other farms were also at increased risk compared with farms without any animal contacts between farms (OR 2.63, 95% CI 1.33-5.41) although this association was not frequency-dependent. Only close animal contacts between farms was directly associated with BVD status in the BN model, however, this approach further untangled other complex associations between correlated management factors, and provided additional important insights into BVD epidemiology. Compared to other countries with intensive production systems, over the fence contact appeared to play a more important role in New Zealand pastoral-based production systems and should be considered when developing strategies for a national BVD control programme.

A Retrospective Cohort Study of an Outbreak of Cryptosporidiosis among Veterinary Students.

An outbreak of gastrointestinal illness occurred among a cohort of 56 veterinary technology and 100 veterinary science students at Massey University over an eight-week period in 2013. This coincided with calving in New Zealand's seasonal dairy farming system and a time when calves with diarrhoea are commonly seen by veterinarians. Laboratory and epidemiological investigations were instigated by MidCentral Public Health Service (MCPHS) in conjunction with the Institute of Veterinary, Animal and Biomedical Sciences (IVABS) at Massey University. Eighty students responded to a questionnaire of which 19 met the case definition, a 24% attack rate. Faecal specimens from seven students contained Cryptosporidium oocysts and Cryptosporidium parvum IIa A18G3R1 was identified from one of the specimens. The inferred median incubation period was five days (range 1-12 days). All of the cases were self-limiting, characterized by diarrhoea, abdominal cramps, and in some cases vomiting, headache, and fever. Having contact with calves with diarrhoea was significantly associated with increased adjusted odds of being a case (OR 10.61, 95% CI 1.87-108.29 for one week of contact; OR 55.05, 95% CI 3.80-1931.18 for two weeks of contact). Outbreaks of cryptosporidiosis had occurred previously among veterinary students at Massey University, but the extremely high infectivity of C. parvum resulted in student illness despite enhanced hygiene precautions.

Curricular Review and Renewal at Massey University: A Process to Implement Improved Learning Practices.

Curriculum managers of the Bachelor of Veterinary Science program at Massey University have undertaken major curricular review every 5-10 years and also made adjustments to the program as a result of student and other stakeholder feedback. New curricula introduced in 2003 and 2013 aimed to address specific stakeholder requirements in the veterinary, agricultural, and allied industries. The new curricula initially sought to strengthen clinical skills but more recently focused on the core professional skill of client communication, the integration of knowledge and clinical skills, and a better understanding of the effects of herd health interventions on farm economics. The need for greater emphasis on the veterinarian's role in One Health at the intersection of humans, animals, and the environment was also recognized. The most recent curricular review was preceded by faculty enlightenment and discussion about innovative models of medical education with a focus on student-centered and integrated learning. A new curriculum was introduced from 2013 that presented more material in its clinical context, attempted to manage curriculum overload through a focus on Day One Competences, implemented vertical and horizontal integration of subjects, and introduced more problem-based and student-centered learning. Regular reviews of student workload were needed to ensure that the objectives were achieved, but student feedback has generally been positive.

Stressors and Protective Factors among Veterinary Students in New Zealand.

A study was undertaken to investigate the stressors faced by veterinary students and the protective factors against those stressors. The study was conducted as a workshop during which students collaborated with their peers through an iterative process to identify personal and external factors that contributed to or protected against stress as a veterinary student, and then to suggest strategies that would protect their mental health and well-being. Workload and assessment were the most commonly reported stressors. Students reported a variety of effective coping strategies and avoidance behaviors, although most of the suggested solutions revolved around organizational change within the university. Students also recognized that their own perspectives, traits, and behavior could enhance their student experience or increase their perceived levels of stress. While it is important that educators monitor student feedback about the program and make changes when required, students must recognize that stress is an expected component of life and develop effective coping strategies. They should develop a balanced view of the positive and negative aspects of the student experience and, ultimately, of working as a veterinary professional.