Disease investigations for equine infectious anemia in Canada (2009-2012) - Retrospective evaluation and risk factor analysis.

This retrospective study describes the detection of equine infectious anemia (EIA) during Canadian Food Inspection Agency (CFIA) disease investigations in Canada, examines aspects of importance for disease control, and evaluates potential animal-level risk factors for EIA in high-risk horses. Based on review of all EIA-positive samples and all samples collected during disease investigations (N = 4553) over a 4-year period (2009 to 2012), 409 EIA cases were detected. Horse owners with EIA cases owned between 1 and 60 affected animals, and 49 horses seroconverted during a disease investigation period. Twenty-nine percent of cases (n = 68) for which this information was available had, or possibly had, clinical signs of EIA. Using a mixed effects logistic regression model, horses in older age groups were at greater odds of having a positive EIA status. The study emphasizes the importance of disease investigation activities when EIA is detected and identifies age as an animal-level risk factor in high-risk horses.

Enquêtes médicales pour l'anémie infectieuse équine au Canada (2009­2012) ­ Évaluation rétrospective et analyse des facteurs de risques. Cette étude rétrospective décrit la détection de l'anémie infectieuse équine (EIA) durant les enquêtes médicales de l'Agence canadienne d'inspection des aliments (CFIA) au Canada, examine les aspects importants pour la maitrise de la maladie, et évalue les facteurs de risque potentiels au niveau des animaux pour l'EIA chez les chevaux à risque élevé. Sur la base d'une revue de tous les échantillons positifs pour l'EIA et tous les échantillons prélevés durant les enquêtes (N = 4553) pendant une période de 4 ans (2009­2012), 409 cas d'EIA furent détectés. Les propriétaires de chevaux avec EIA possédaient entre 1 et 60 animaux affectés, et 49 chevaux ont séro-converti durant une période d'enquête. Vingt-neuf pourcents des cas (n = 68) pour lesquels l'information était disponible avaient, ou avaient possiblement eu, des signes cliniques d'EIA. Utilisant un modèle de régression logistique à effets mixtes, les chevaux des groupes d'animaux plus âgés étaient à plus grand risque d'avoir un statut positif pour l'EIA. Cette étude fait ressortir l'importance des activités d'enquêtes médicales lorsque l'EIA est détectée et identifie l'âge comme étant un facteur de risque au niveau de l'animal chez les chevaux à risque élevé.(Traduit par Dr Serge Messier).

A retrospective study of owner-requested testing as surveillance for equine infectious anemia in Canada (2009-2012).

This retrospective study was undertaken to estimate i) the surveillance coverage for equine infectious anemia (EIA) based on owner-requested testing, and ii) the incidence of case detection from this surveillance activity to inform a review of Canada's national disease control strategy. Based on sample submissions by accredited veterinarians to laboratories CFIA-approved for EIA testing between 2009 and 2012, the estimated national surveillance coverage was 14% for all years, and 72 cases of EIA were detected. The annual national incidence of EIA detection ranged from 0.03 to 0.08 cases/1000 horses. On average, a greater proportion of the horse population was tested in eastern Canada (32%) than in western Canada (6%, P < 0.0001). The cumulative incidence of EIA detection was higher in western Canada (0.25 cases/1000 horses) than in eastern Canada (0.02 cases/1000 horses, P < 0.0001). This study identified regional differences in owner-requested EIA testing and case detection resulting from this testing activity.

Étude rétrospective des tests demandés par les propriétaires comme surveillance pour l'anémie infectieuse équine au Canada (2009­2012). Cette étude rétrospective a été entreprise afin d'estimer i) la couverture de surveillance pour l'anémie infectieuse équine (AIE) basée sur les tests demandés par les propriétaires et ii) l'incidence de détection des cas à partir de cette activité de surveillance pour documenter un examen de la stratégie nationale de contrôle des maladies du Canada. L'estimation de la couverture nationale de surveillance, basée sur les soumissions d'échantillons par les vétérinaires autorisés aux laboratoires approuvés par l'ACIA pour l'AIE entre 2009 et 2012, était de 14 % pour toutes les années et 72 cas d'AIE ont été détectés. L'incidence nationale annuelle de la détection de l'AIE variait de 0,03 à 0,08 cas/1000 chevaux. En moyenne, une proportion supérieure de la population équine de l'Est du Canada (32 %) subissait des tests par rapport à l'Ouest canadien (6 %, P < 0,0001). L'incidence cumulative de la détection de l'AIE était supérieure dans l'Ouest canadien (0,25 cas/1000 chevaux) par rapport à l'Est du Canada (0,02 cas/1000 chevaux, P < 0,0001). Cette étude a identifié des différences régionales pour les tests de l'AIE demandés par les propriétaires et la détection des cas découlant de cette activité d'épreuve diagnostique.(Traduit par Isabelle Vallières).

A comparative analysis of ethical and professional challenges experienced by Australian and U.S. genetic counselors.

Ethical issues are an inevitable part of genetic counseling practice. Prior research identified 16 domains of ethical and professional challenges encountered by practitioners in the United States. In order to further validate these domains, the present study surveyed Australian genetic counselors. Sixty-three respondents rated the frequency with which they encountered each domain, and 39 individuals also provided personal anecdotes detailing their most challenging ethical and professional dilemmas. Every domain reportedly was experienced by the Australian sample. However, there were some differences between Australian respondents and U.S. genetic counselors in frequencies of domain occurrence, and in strategies recommended for resolving them. Several anecdotes illustrate challenging situations due to Australia's geography, universal healthcare system, and the genetic counseling profession's evolution in that country. The results generally validate domains identified for U.S. genetic counselors. They further suggest that certain ethical issues may manifest in ways unique to a given country, and therefore they must be addressed in a culturally-appropriate manner.

Religion versus ethnicity as predictors of unprotected vaginal intercourse among young adults.

BACKGROUND: Young adults in North America are at increasing risk for contracting HIV and sexually transmissible infections (STI). Racial differences in HIV or STI risk are well documented, but other cultural and demographic factors contributing to HIV or STI risk are poorly understood. Although religion may play an important role in sexual behaviour, little research has explored its association with sexual attitudes, beliefs and practices. The present study examined how ethnicity, religion, HIV knowledge and attitudes, and other demographic factors are associated with engaging in unprotected vaginal intercourse (UVI) in a diverse sample of unmarried young adults. METHODS: A cross-sectional study of 666 unmarried university students was conducted from 2005 to 2007, with participants completing an anonymous questionnaire on sexual attitudes and health for course credit. RESULTS: Approximately 50% of the respondents had engaged in any vaginal intercourse and 32.2% had engaged in UVI in the past 6 months. Multivariable analyses showed that increasing age, being in a relationship for more than 6 months, greater HIV knowledge, stronger attitudes supporting the use of condoms, and religion (but not ethnicity) were associated with engaging in UVI. Among the sexually active subset of the sample (n=332), religion was the only predictor of engaging in UVI. CONCLUSION: Ethnicity, which is often considered an important variable in sexual health research, does not appear to be associated with UVI when taking into account other demographic variables, particularly religion. Consideration of religion may be important in devising HIV prevention interventions, in order to implement them in accordance with particular religious beliefs.

Contemporary New Zealand coefficients for the Trauma Injury Severity Score: TRISS(NZ).

AIMS: To develop local contemporary coefficients for the Trauma Injury Severity Score in New Zealand, TRISS(NZ), and to evaluate their performance at predicting survival against the original TRISS coefficients. METHODS: Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until presentation at Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Coefficients were estimated using ordinary and multilevel mixed-effects logistic regression models. RESULTS: 1735 eligible patients were identified, 1672 (96%) injured from a blunt mechanism and 63 (4%) from a penetrating mechanism. For blunt mechanism trauma, 1250 (75%) were male and average age was 38 years (range: 15-94 years). TRISS information was available for 1565 patients of whom 204 (13%) died. Area under the Receiver Operating Characteristic (ROC) curves was 0.901 (95%CI: 0.879-0.923) for the TRISS(NZ) model and 0.890 (95% CI: 0.866-0.913) for TRISS (P<0.001). Insufficient data were available to determine coefficients for penetrating mechanism TRISS(NZ) models. CONCLUSIONS: Both TRISS models accurately predicted survival for blunt mechanism trauma. However, TRISS(NZ) coefficients were statistically superior to TRISS coefficients. A strong case exists for replacing TRISS coefficients in the New Zealand benchmarking software with these updated TRISS(NZ) estimates.

Using Trauma Injury Severity Score (TRISS) variables to predict length of hospital stay following trauma in New Zealand.

AIM: To develop and assess the predictive capabilities of a statistical model that relates routinely collected Trauma Injury Severity Score (TRISS) variables to length of hospital stay (LOS) in survivors of traumatic injury. METHOD: Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until discharge from Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Cubic-root transformed LOS was analysed using two-level mixed-effects regression models. RESULTS: 1498 eligible patients were identified, 1446 (97%) injured from a blunt mechanism and 52 (3%) from a penetrating mechanism. For blunt mechanism trauma, 1096 (76%) were male, average age was 37 years (range: 15-94 years), and LOS and TRISS score information was available for 1362 patients. Spearman's correlation and the median absolute prediction error between LOS and the original TRISS model was p=0.31 and 10.8 days, respectively, and between LOS and the final multivariable two-level mixed-effects regression model was p=0.38 and 6.0 days, respectively. Insufficient data were available for the analysis of penetrating mechanism models. CONCLUSIONS: Neither the original TRISS model nor the refined model has sufficient ability to accurately or reliably predict LOS. Additional predictor variables for LOS and other indicators for morbidity need to be considered.

Social anxiety and HIV transmission risk among HIV-seropositive male patients.

The role of psychological factors in predicting HIV sexual transmission risk behavior is increasingly of interest in prevention research. Social anxiety, or anxiety about being evaluated in interpersonal situations, is associated with unprotected insertive anal intercourse among young men who have sex with men (MSM) and with other behavioral risk factors for unprotected intercourse, such as depression, smoking, alcohol use, and drug use. Social anxiety may be especially relevant in understanding HIV risk among HIV-seropositive men, given its stronger association with unprotected insertive than with receptive anal intercourse. In the present study, for which participants were recruited between October 2002 and May 2003, HIV-positive men attending regularly scheduled primary care medical appointments at a community HIV clinic were approached by research personnel and informed about the study topic and procedures. Ninety percent of patients approached agreed to participate, resulting in a sample of 206 patients. The sample was primarily African American, unemployed, of low educational level, and 95% of the sample had an AIDS diagnosis. The present study replicated and extended previous research from community samples by demonstrating an association between social anxiety and unprotected insertive anal intercourse with non-HIV-positive partners in a clinical sample of HIV-positive MSM and men who have sex with women (MSW). This association was maintained controlling for depression, smoking, and club drug use. Social anxiety is a relatively robust risk factor for unprotected insertive anal intercourse among MSM. Future work should examine the mechanisms by which social anxiety is associated with sexual risk among MSM.

Opposing effects of phorbol-12-myristate-13-acetate, an activator of protein kinase C, on the signaling of structurally related human dopamine D1 and D5 receptors.

The 'cross-talk' between different types of neurotransmitters through second messenger pathways represents a major regulatory mechanism in neuronal function. We investigated the effects of activation of protein kinase C (PKC) on cAMP-dependent signaling by structurally related human D1-like dopaminergic receptors. Human embryonic kidney 293 (HEK293) cells expressing D1 or D5 receptors were pretreated with phorbol-12-myristate-13-acetate (PMA), a potent activator of PKC, followed by analysis of dopamine-mediated receptor activation using whole cell cAMP assays. Unpredictably, PKC activation had completely opposite effects on D1 and D5 receptor signaling. PMA dramatically augmented agonist-evoked D1 receptor signaling, whereas constitutive and dopamine-mediated D5 receptor activation were rapidly blunted. RT-PCR and immunoblotting analyses showed that phorbol ester-regulated PKC isozymes (conventional: alpha, betaI, betaII, gamma; novel: delta, epsilon, eta, theta) and protein kinase D (PKCmicro) are expressed in HEK293 cells. PMA appears to mediate these contrasting effects through the activation of Ca2+-independent novel PKC isoforms as revealed by specific inhibitors, bisindolylmaleimide I, Gö6976, and Gö6983. The finding that cross-talk between PKC and cAMP pathways can produce such opposite outcomes following the activation of structurally similar D1-like receptor subtypes is novel and further strengthens the view that D1 and D5 receptors serve distinct functions in the mammalian nervous and endocrine systems.

The Genetic Counseling Workplace-An Australasian Perspective. A National Study of Workplace Issues for Genetic Counselors and Associate Genetic Counselors.

Genetic counseling in Australasia (Australia and New Zealand) has been recognized as a profession since the 1980s and has steadily expanded over the past 20 years. The demography of major cities with metropolitan sprawl and sparsely populated rural areas has led to the establishment of 3 types of genetics units: main units in cities, metropolitan outreach, and rural outreach units. A questionnaire was developed to obtain information about the needs, resources, and day-to-day operation of the genetic counselors. The questionnaire addressed the areas of resource availability, professional development, responsibility of genetic counselors in the clinical setting, and their involvement in promotion of the service and public education. Differences observed between the 3 settings in all of these areas included large clinical loads for metropolitan outreach counselors, varying responsibilities in the clinical setting, and a lack of support and resources for rural outreach counselors. Australasian Genetic counselors were found to have a significant interest in developing mechanisms for supervision and were keenly interested in maintaining credentials and professional role development. The results of this study allows genetic counselors themselves to have a better understanding of the roles of their colleagues in the different units; they can also be used by service providers in establishing and supporting genetic counselors, and identifying inequalities and deficiencies in the different practice areas.