Regression calibration of self-reported mobile phone use to optimize quantitative risk estimation in the COSMOS study

The Cohort Study of Mobile Phone Use and Health (COSMOS) has repeatedly collected self-reported and operator-recorded data on mobile phone use. Assessing health effects using self-reported information is prone to measurement error, but operator data were available prospectively for only part of the study population and did not cover past mobile phone use. To optimize the available data and reduce bias, we evaluated different statistical approaches for constructing mobile phone exposure histories within COSMOS. We evaluated and compared the performance of 4 regression calibration (RC) methods (simple, direct, inverse, and generalized additive model for location, shape, and scale), complete-case analysis, and multiple imputation in a simulation study with a binary health outcome. We used self-reported and operator-recorded mobile phone call data collected at baseline (2007-2012) from participants in Denmark, Finland, the Netherlands, Sweden, and the United Kingdom. Parameter estimates obtained using simple, direct, and inverse RC methods were associated with less bias and lower mean squared error than those obtained with complete-case analysis or multiple imputation. We showed that RC methods resulted in more accurate estimation of the relationship between mobile phone use and health outcomes by combining self-reported data with objective operator-recorded data available for a subset of participants.

Headache in the international cohort study of mobile phone use and health (COSMOS) in the Netherlands and the United Kingdom

Headache is a common condition with a substantial burden of disease worldwide. Concerns have been raised over the potential impact of long-term mobile phone use on headache due to radiofrequency electromagnetic fields (RF-EMFs). We explored prospectively the association between mobile phone use at baseline (2009-2012) and headache at follow-up (2015-2018) by analysing pooled data consisting of the Dutch and UK cohorts of the Cohort Study of Mobile Phone Use and Health (COSMOS) (N = 78,437). Frequency of headache, migraine, and information on mobile phone use, including use of hands-free devices and frequency of texting, were self-reported. We collected objective operator data to obtain regression calibrated estimates of voice call duration. In the model mutually adjusted for call-time and text messaging, participants in the high category of call-time showed an adjusted odds ratio (OR) of 1.04 (95 % CI: 0.94-1.15), with no clear trend of reporting headache with increasing call-time. However, we found an increased risk of weekly headache (OR = 1.40, 95 % CI: 1.25-1.56) in the high category of text messaging, with a clear increase in reporting headache with increasing texting. Due to the negligible exposure to RF-EMFs from texting, our results suggest that mechanisms other than RF-EMFs are responsible for the increased risk of headache that we found among mobile phone users.

Reduced incidence of tick paralysis cases in dogs and cats at two emergency clinics in South-East Queensland since 2015: new generation prophylactics as possible explanatory variables

INTRODUCTION

This study aimed to determine the incidence of canine and feline tick paralysis cases presenting to two veterinary emergency hospitals before and after the introduction of new generation prophylactic acaricides.

METHODS

This was a retrospective study, investigating the number of tick paralysis cases presenting to two emergency and critical care veterinary hospitals in South-East Queensland, from 2008 to 2021. A total of 10,914 dogs and 3696 cats were included over the course of the study. To assess if the introduction of new generation prophylactics in 2015 has coincided with any variation in case numbers, data for each species were analysed graphically and numerically in the first instance, then interrupted time series analyses were performed for the dog and cat data independently.

RESULTS

Accounting for seasonal and climatic variation, we estimated a 54.8% reduction in dog (95% CI 45.3%-62.7%) and 44% reduction in cat (95% CI 19.5%-46%) tick paralysis cases presenting to these two clinics. This reduction corresponded with the timing of new generation prophylactic agents being introduced, including isoxazolines and imidacloprid/flumethrin impregnated collars.

CONCLUSION

In the population studied, a significant reduction in the incidence of tick paralysis cases treated by veterinarians has occurred from 2015 onwards and was found to be associated with the timing of the release of new generation acaricidal products.

Factors influencing dairy cattle farmer use of antimicrobials on farms in New South Wales, Australia

Antimicrobial use (AMU) in the food chain is a potential driver of antimicrobial resistance. Despite Australia's strong regulation of AMU limited to veterinary prescriptions, a proportion of empirical antimicrobial treatments are administered by dairy farmers to manage common cattle health problems. This cross-sectional survey identified key influences on AMU by dairy cattle farmers within New South Wales, Australia, to detect opportunities for antimicrobial stewardship (AMS) engagement. The study identified existing relationships, resources and attitudes of the dairy farmers that could be optimised for on-farm AMS strategies. Farmers were most highly influenced by veterinary advice and clinical signs of the animal followed by the withholding period and the potential for antimicrobial resistance development. Farmers' high confidence regarding their own knowledge of antimicrobials (>90%), their high regard for veterinary advice (>90%) and high rate of veterinary health care plan use (69%) provides a strong framework to build the profile and practice of AMS on dairy farms. Positive engagement by dairy farmers (survey response of 20%), was achieved by working with the NSW Food Authority. Despite respondents reporting low reliance on formal (government and commercial) organisations for information about AMU, their engagement demonstrates an opportunity for groups with unparalleled access to dairy farmers to drive AMS. An association between frequent use of veterinary advice and respondents keeping ceftiofur on-farm requires further investigation. Quantitative and qualitative analysis of on-farm resources, decision-making, and practices is required to understand how practices relate to veterinary advice and accepted standards of appropriate AMU on dairy farms.

Assessment of Psychosocial Functioning in a Large Cohort of Patients with Schizophrenia

BACKGROUND

This study addresses the question of whether psychosocial functioning measured by the Personal and Social Performance (PSP) Scale is related to various psychopathological measures in a cohort of patients with schizophrenia.

METHODS

The 'Neuroleptic Strategy Study' (NeSSy) performed at 14 German hospitals between 2010 and 2013 compared two treatment strategies instead of individual drugs. Secondary end-points were the two PSP scales as well as measures of quality of life (SF-36) and the Positive and Negative Syndrome Scale (PANSS).

RESULTS

149 patients were randomised. There was no difference between the two treatment strategies (first-generation versus second-generation antipsychotics) with regard to the PSP. There were differences in doctors' assessments regarding psychosocial functioning compared with patients' own assessments. Furthermore, there were relationships between the PSP and quality of life, level of skills (ICF), and severity of disease (PANSS), level of sexual activities and poor well-being under antipsychotic medication but not with cognitive changes.

CONCLUSIONS

The findings on psychosocial functioning of patients with schizophrenia related to severity and skill level could be confirmed. Further findings were the correlation between psychosocial functioning and quality of life, well-being under treatment, and sexuality what emphasizes the substantial importance of a reduced psychosocial functioning.

SnakeMap: four years of experience with a national small animal snake envenomation registry

SnakeMap is a national cloud-based, veterinary snakebite registry. It was designed to prospectively collect data of the clinical circumstances and temporospatial information on cases of snake envenomation in dogs and cats. We herein introduce the project and summarise the data from the first 4 years of SnakeMap. The registry is a veterinary community-based online database allowing case entry from veterinary hospitals across Australia. Registry data comprise hospital characteristics, patient characteristics, envenoming snake type, treatment and outcome variables, including time and geolocation of the snake bite. We present summative information on select key variables from the SnakeMap registry (1 July 2015 to 30 June 2019). Twenty-eight hospitals from 6 states/territories entered 624 cases into the registry, including 419 dogs (67%) and 205 cats (33%). Bite time was available in 216 animals of which 90 (42%) were reported to be bitten in the 3 hours between 03:00 pm and 05:59 pm; median bite to presentation interval was 60 (interquartile range [IQR] 30, 211) minutes in dogs and 95 (IQR 41, 238) minutes in cats. Bites occurred in the owner's yard in 356 dogs (85%) and 53 cats (26%). A snake venom detection kit was used in 172 cases (28%) and antivenom was administered in 523 cases (85%). Most animals (n = 534, 88%) survived to discharge (median hospitalisation of 25 [IQR 16, 62] hours). SnakeMap effectively collects relevant clinical data from dogs and cats with presumed snake bite and provides locally specific information on the epidemiology of snake envenomation in small animals.

Dairy goat producers' understanding, knowledge and attitudes towards biosecurity and Q-fever in Australia

The Australian dairy goat sector is an emerging animal industry undergoing rapid expansion. Limited information is available within this industry in relation to socio-demographic characteristics and biosecurity implementation. Q-Fever, caused by the bacterium Coxiella burnetii, is a zoonotic disease endemic in Australia, with a range of domestic and wild-animal reservoir species, including goats, with infected pregnant goats posing a significant public health risk. The aim of the current study was to investigate the socio-demographics of Australian dairy goat producers, their biosecurity implementation and levels of understanding, knowledge and attitudes towards Q-Fever. To achieve this aim, a cross-sectional study was conducted, using an online survey and follow-up semi-structured interviews among dairy goat producers. A total of 106 goat producers participated in the online survey (35.3% response rate) and 14 participated in the semi-structured interviews. Findings from this study suggest that most goat producers implement biosecurity practices related to direct animal husbandry, such as separating sick goats (86%), vaccinations (79%) and providing separate kidding space (75%); and, practices minimizing the risk of disease introduction, such as maintaining boundary fences (86%) and isolating incoming animals (67%). However, implementation of other biosecurity practices, such as keeping records of visitors and visitor biosecurity requirements, was inadequate. Furthermore, this study identifies a deficit of knowledge and understanding surrounding Q-Fever in the Australian dairy goat sector, and a disconnect between producers' perception of risk and implementation of known appropriate biosecurity measures. The research has identified that producers rely on 'trusted' community networks to provide advice on biosecurity implementation, due to a perceived absence of industry-specific, reputable information sources. Producers identified those outside of these networks as the 'other'. The creation of this other allows producers to deflect responsibility for individual biosecurity on to the other. A multifaceted approach is necessary to increase knowledge, understanding and perception of risk surrounding Q-fever, and promote positive uptake of biosecurity measures, for improved outcomes for animal and human health.

Durch die kontinuierliche Blutdruckmessung lässt sich ein transienter orthostatischer Blutdruckabfall bei idiopathischer REM-Schlaf-Verhaltensstörung nachweisen

Ziel der Studie Es gibt wenige Daten zum orthostatischen Blutdruck (BD) Verhalten und Veränderungen der Herzratenvariabilität (HRV) bei idiopathischer REM-Schlaf-Verhaltensstörung (iRBD). Unsere Hypothese war, dass orthostatische BD Veränderungen vorübergehend sind.

Methodik Wir untersuchten 16 männliche iRBD Patienten und 15 altersgematchte männliche Kontrollprobanden (HC) im Hinblick auf eine Dysautonomie, HRV und kontinuierliche BD Messung während der Kipptischuntersuchung.

Ergebnisse Die BD Abfälle in den ersten 5 Minuten Stehzeit waren bei iRBD Patienten signifikant größer. IRBD Patienten hatten häufiger eine reduzierte respiratorische Sinusarrhythmie (RSA).

Schlussfolgerungen Mittels kontinuierlicher BD Messung ließen sich transiente orthostatische BD Abfälle bei iRBD detektieren. Longitudinale Daten werden zeigen, ob diese Änderungen Hinweise für eine periphere sympathoneurale Dysfunktion darstellen und frühe Marker einer späteren orthostatischen Hypotonie sein können.

Autonomic dysfunction of gastric motility in major depression

BACKGROUND

Patients suffering from major depressive disorder (MDD) often complain about somatic symptoms. Cardiac complaints have been examined predominantly. However, gastrointestinal complaints are also reported frequently and are associated with worse outcomes. The research concerning changes in gastric motility of these patients is rather sparse. The aim of our study was to determine dysfunction of gastric motility and gastrointestinal symptoms in MDD. The duration and severity of MDD were examined regarding its influence over gastric emptying.

METHODS

Gastric emptying was determined by a ¹³C-acetate breath test in patients with MDD (n = 29) and healthy control subjects (n = 51). Prior to this, depressive illness was operationalized using external and self-assessment scales (HAMD-21, MADRS, BDI, CGI). Whether the severity or duration of MDD influenced the gastric emptying parameters was examined using Spearman's correlation. In addition, autonomic complaints were recorded by means of an ANS score. Each ANS score item was determined using a Mann-Whitney U or Kruskal-Wallis test concerning the gastric emptying parameters.

RESULTS

There was a significant difference in the parameters of the maximum gastric emptying rate (T_max) and gastric half emptying time T_1/2b between patients with MDD and healthy control subjects (T_max 66.21min vs 53.35min, p < 0.006, T_1/2b 207.59min vs 133.27min, p < 0.005). There was a significant negative correlation between T_max and the severity of MDD determined with the depression rating scales BDI (Spearman's rank - 0.521, p = 0.013) and HAMD-21 (r - 0.384, p = 0.048). No correlation was found between the duration of MDD and the maximum gastric emptying rate (r - 0.125, p = 0.519) and gastric half emptying time (r - 0.62, p = 0.749).

CONCLUSION

Gastrointestinal motility is significantly impaired in patients with MDD compared to healthy control subjects. Autonomic complaints were indicated frequently in MDD patients. The duration of MDD had no influence over the time of gastric emptying. There was a significant negative correlation between the severity of MDD and T_max, indicating that the T_max was reached earlier with the progression of MDD. The slowing of gastric motility in MDD patients is likely a result of a dysfunction of the autonomic nervous system.

Equine chlamydiosis-An emerging infectious disease requiring a one health surveillance approach

Psittacosis is a rare but potentially fatal zoonosis caused by Chlamydia psittaci, an organism that is typically associated with bird contact. However C. psittaci is capable of infecting other non-avian hosts, such as horses, sheep, cattle and goats. Stud staff and veterinarians have significant exposure to parturient animals and reproductive materials in their routine work. To investigate the zoonotic potential associated with the emergence of C. psittaci as an abortifacient agent in horses, we established a programme of joint human and animal surveillance in a sentinel horse-breeding region in Australia. This programme comprised cross-notification of equine cases to public health agencies, and active follow-up of known human contacts, including stud workers, foaling staff, veterinarians and laboratory staff. We identified no confirmed cases of acute psittacosis despite intensive surveillance and testing of heavily exposed contacts; however, further work in the area is needed.

Transmission of highly virulent community-associated MRSA ST93 and livestock-associated MRSA ST398 between humans and pigs in Australia

Pigs have been recognised as a reservoir of livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in Europe, Asia and North America. However, little is known about the presence and distribution of MRSA in the Australian pig population and pig industry. This study describes the presence, distribution and molecular characteristics of the human adapted Australian CA-MRSA ST93 isolated from pigs, people, and the environment within a piggery. Isolates were subjected to antibiotic susceptibility testing, DNA microarray, whole genome sequencing, multi locus sequence typing, virulence and resistance gene characterization and phylogenetic analysis. MRSA were isolated from 60% (n = 52) of farm workers where 84% of isolates returned ST93 and the rest ST398. Of the thirty-one pig isolates tested further, an equal number of ST398 and ST93 (15 each) and one as ST30-V were identified. Four of six environmental isolates were identified as ST93 and two as ST398. This study has identified for the first time in Australia the occurrence of CA-MRSA ST93 and LA-MRSA ST398 amongst farm workers, pigs, and the farm environment. Comparative genome analysis indicates that ST398 is likely to have been introduced into Australia from Europe or North America. This study also reports the first linezolid resistant MRSA isolated in Australia.

Demographic and preliminary employment data of the first two graduate cohorts from a rural veterinary school

OBJECTIVE

To report initial career experiences and graduate employment destinations 1 and 5 years following graduation of the 67 graduates from the first two graduating classes of the veterinary science program at Charles Sturt University.

DESIGN

Online survey of graduates from the 2010 and 2011 cohorts undertaken 12 months following course completion and descriptive data on graduate practice locations 5 years post-graduation.

PROCEDURE

Questions covered general demographic information, issues relating to work-life balance and factors influencing vocational choices. Descriptive statistics and qualitative responses are reported, with comparisons between continuous variables by two-sample t-test and between categories by Chi-square analyses. Significance was set at P < 0.05. Graduates' locations 5 years after graduation were obtained from veterinary registration details and staff contact with graduates.

RESULTS

Complete survey responses were received from 39 graduates of whom 34 were employed in regional areas, 1 in a very remote area, 3 in major cities and 1 overseas. Hours worked and salary received were consistent with other survey data, with new graduates working in regional practices earning slightly more than those working in metropolitan practices. At 5 years following graduation, the majority (56/61, 92%) remained in rural or regional Australian veterinary practices, with a further five graduates overseas and one lost to follow-up.

CONCLUSION

This study supported the selection criteria and educational approaches at CSU in establishing most of the new graduates in rural and regional mixed veterinary practice.

Epidemiological investigation of grass seed foreign body-related disease in dogs of the Riverina District of rural Australia

OBJECTIVE

To characterise disease presentations caused by grass seed foreign body-related disease (GSFBD) in dogs, identify predisposing risk factors and suggest effective prevention strategies.

METHODS

A retrospective, case-control, telephone survey was conducted to obtain information on GSFBD in dogs from the Riverina district of New South Wales (NSW). Additionally, retrospective case records were obtained from Wagga Wagga Veterinary Hospital and Charles Sturt University Veterinary Teaching Hospital over the period July 2006 to October 2011. Signalment, history, investigative strategies, location and severity of lesion(s), cost of therapy, length of hospitalisation, recurrence rate and microbiology data were recorded.

RESULTS

Cases (473 dogs) meeting stringent inclusion criteria were identified. GSFBD comprised 2.0% of hospital presentations. Breeds with high-density coats were overrepresented. Otitis externa was the most common manifestation of GSFBD in the general practice (47%). In the referral practice pyothorax was the most common entity (34%). In both practices the range of clinical manifestations was broad, including a small number of dogs with catastrophic intracranial disease. Univariable and multivariable logistic regression analyses demonstrated dogs with GSFBD had 3-fold greater odds of having medium coats than short coats and 5-fold less odds of being groomed.

CONCLUSIONS AND CLINICAL RELEVANCE

Grass seeds are a major cause of disease in the dogs of south-west rural NSW, with presentations ranging from mild lameness to severe neurological disease. Some protection from GSFBD was achieved with frequent grooming. Clipping or coat searching without grooming was ineffective as a prevention strategy.

THE EFFECT OF MATURITY ON HEART RATE RESPONSES DURING TRAINING AND TESTING IN POSTPUBESCENT FEMALE VOLLEYBALL PLAYERS

The aim of this study was to examine the effect of maturity, assessed as difference between chronological age and age at peak height velocity, on heart rate (HR) responses to maximal and submaximal laboratory and field exercises. Twenty-eight postpubescent female volleyball players participated in the present study (age 13.8 (0.6) yr, body mass 62.5 (8.2) kg and height 1.73 (0.05) m; mean (standard deviation)). They were divided into two groups with regards to their maturation: less matured (LM) and more matured (MM). In laboratory, HR was recorded during 5 min rest, physical working capacity in heart rate 170 bpm, 3 min step test, 30 s Bosco test and Wingate anaerobic test (WAnT) were performed. In field, a 70 min training session (consisted by three parts: warm-up, 1 x 1 drills and team drills) was monitored and 20 m shuttle run endurance test was performed. There was significant difference between LM and MM groups over HR responses (%HR reserve, %HRR) to exercise training (F(2,21) = 6.08, p = 0.008, η2 = 0.37). There was a main effect of part session of exercise program on HR responses with the highest intensity recorded in 1 x 1 drills (-75% HRR) and the lowest in team drills (-60% HRR in LM and -65% HRR in MM). There was also a moderate effect of maturity on HR during cycling against 90 W and in the WAnT, and small effect on HR during cycling against 60 W, in the end of the step test, Bosco test and running endurance test, where the highest scores were recorded in LM. Based on the findings of the present study, it was concluded that maturity exerted an effect of small to moderate magnitude on H R responses in a laboratory setting and this should be taken into account by coaches and trainers when evaluating physiological characteristics.

In vitro assessment of aiming bias in the frontal plane during orthopaedic drilling procedures

Drilling trials were performed using drilling boards incorporating pairs of 22 mm polyethylene tubes mounted horizontally. The tubes were premarked with 20, 0.5 mm deep notches along the centre of their upper surface representing the starting point for each drilling trial. Volunteers were instructed to drill 20 straight holes across the tube until they penetrated both walls. Kirschner wires were inserted through each of the drill holes until they made indentations into the base board. Deviation of each mark from mid-line was measured using digital callipers. The measured values were used to calculate deviation angles to the left (negative values) or right (positive values). Trials were performed with the drill and guide held in the surgeon's line-of-sight (LOS) and with 300 mm offset (OFF). A systematic error (aiming bias) was identified in all individuals. Overall, left-hander's drilling action was skewed to the left and right-hander's drilling action was skewed to the right. Using LOS technique, mean overall bias was 2.3° (range 0°-7.7°) to the left for left-handers and 1.5(o) (range 0.3°-3.1°) to the right for right-handers. Surprisingly, aiming bias was greater for LOS than for OFF, although the difference for this comparison was not statistically significant.