Development and evaluation of a high-fidelity canine patient simulator for veterinary clinical training

High-fidelity human patient simulators have been used for decades in medical education to provide opportunities for students to practice technical skills, diagnostic and therapeutic planning, and communication skills in a safe environment. A high-fidelity canine patient simulator (CPS) was developed using components from a human patient simulator and a low-fidelity foam core canine mannequin. Ninety-six veterinary students participated in cardiopulmonary arrest scenarios in groups of three to five students. Afterwards, participants were asked to complete an anonymous online survey describing their experiences. A total of 70 students (73%) completed the survey. All of the students (100%) felt that the simulator session expanded their cardiopulmonary resuscitation (CPR) knowledge base, and 97% responded that their skills and abilities had improved. Students also expressed positive opinions about the CPS, with 89% agreeing or strongly agreeing that the CPS was realistic and 73% agreeing or strongly agreeing that the scenarios generated emotions similar to real clinical situations. Most participants (98.5%) agreed or strongly agreed that the simulator was an engaging learning experience. Students commonly commented that the simulations allowed them to practice communication and teamwork skills and were more effective than paper-based, problem-oriented learning opportunities and lecture. Students also commented that they wanted more opportunities to participate in simulation exercises. These results suggest that high-fidelity veterinary simulation is an engaging educational methodology that addresses some limitations of other forms of problem-based learning. More studies are needed to quantitatively determine the effectiveness of this novel veterinary educational technology in comparison with more traditional approaches.     

Economic evaluation of the surveillance and intervention programme for bluetongue virus serotype 8 in Switzerland

Empirical analyses founded on sound economic principles are essential in advising policy makers on the efficiency of resource use for disease mitigation. Surveillance and intervention are resource-using activities directed at mitigation. Surveillance helps to offset negative disease effects by promoting successful intervention. Intervention is the process of implementing measures (e.g. vaccination or medication) to reduce or remove a hazard in a population. The scale and ratios in which the two are combined affect the efficiency of mitigation, its costs, benefits, and thus net effect on society's well-being. The Swiss national mitigation programme for bluetongue virus serotype 8 was used as case study to investigate the economic efficiency of mitigation. In 2008, Switzerland implemented a vaccination programme to avoid and reduce disease and infection in its ruminant population. To monitor the vaccination programme and the vector dynamics, a surveillance system consisting of serological and entomological surveillance was established. Retrospective analyses for the years 2008-2009 and prospective analyses for the years 2010-2012 were conducted to investigate if the mitigation programme was economically beneficial. In the retrospective analysis, the implemented programme (=comparative scenario) was compared to a hypothesised baseline scenario of voluntary vaccination and surveillance. In the prospective analysis, the comparative scenario assumed to continue was compared to two baseline scenarios: one of voluntary vaccination combined with surveillance and one of no vaccination combined with surveillance. For each scenario, monetary surveillance, intervention and disease costs were calculated. The comparison of baseline and comparative scenarios yielded estimates for the total benefit (=disease costs avoided), margin over intervention cost and the net value of the programme. For 2008-2009, in aggregate, the mean biannual total benefit was 17.46 m Swiss francs (CHF) (1CHF=0.66€ at the time of analysis) and the mean net benefit after subtraction of the intervention and surveillance cost was 3.95 m CHF. For the three years 2010-2012, overall net costs were estimated at 12.93 m and 8.11 m CHF, respectively, for comparison of the implemented mitigation programme with the two baseline scenarios. It was concluded that the surveillance and intervention programme implemented in 2008-2009 was economically beneficial, while its continuation in the same form in 2010-2012 would produce net costs. These costs were due to the mean intervention cost remaining constant at a level of approximately 11 m CHF per year while the mean total benefit would be gradually reduced in 2010-2012 due to the reduced occurrence of disease in a fully vaccinated population.     

Teaching of veterinary parasitology: the Italian perspective

The curriculum in veterinary medicine in Italy is undergoing important changes, as in the rest of Europe. The 2001 fall semester will mark the beginning of a new format for the degree in veterinary medicine and these changes will obviously affect the teaching of veterinary parasitology. In Italy, veterinary parasitology is usually taught in the third year with a disciplinary approach, similar to that described by Euzéby [Vet. Parasitol. 64 (1996) 21] and Eckert [Vet. Parasitol. 88 (2000) 117]. Approximately 90 h of lectures and 40 h of laboratory are offered and are usually divided into parasitology, followed by parasitic diseases. A more problem-oriented approach to parasitology is offered to fifth-year students within several professional routes (large animal medicine, small animal medicine, hygiene and food safety, etc.), amounting to approximately 15-60 h per student. Indeed, in the last year of study, there are less students and it is possible to present clinical cases and orient the students towards team work and critical discussion. This new curriculum guarantees a reduction in the number of lecture hours and an increase in both laboratory work and personal study, as suggested by the guidelines of the European association of establishment for veterinary education (EAEVE).     

Spectrophotometric assessment of peritoneal fluid haemoglobin in colic horses: an aid to selecting medical vs. surgical treatment

In a case-control study in colic horses the ability of spectrophotometric measurement of the haemoglobin concentration in the peritoneal fluid supernatant and visual assessment of the colour of peritoneal fluid supernatant to differentiate between surgical and medical treatment of colic was assessed. Based on previous studies, which have found anda association between peritoneal fluid colour and the kind of treatment required, our hypothesis was that the peritoneal fluid haemoglobin concentration would be higher in horses requiring surgical intervention than in horses amenable to medical treatment. Seventy-four horses admitted to a teaching hospital were included. Thirty-five horses were classified as requiring surgery and 39 medical treatment. Logistic regression revealed a significant (P < 0.0001) association between the haemoglobin concentration measured with the spectrophotometer and the need for surgical treatment. Odds ratio for an increase in haemoglobin concentration of 0.01 mmol/l was 6.4, which means that the odds for 'need for surgical treatment' increased when peritoneal fluid haemoglobin concentration increased. When used as a diagnostic test with a threshold of 0.01 mmol/l haemoglobin for selecting surgical vs. medical treatment, sensitivity was 80% and specificity 82%, whereas simple visual assessment had a sensitivity of only 51% and a specificity of 95%.     

Breed differences on the plasma availability of moxidectin administered pour-on to calves

The pharmacokinetic profile of avermectin and milbemycin compounds is affected by different drug- and host-related factors. This work reports the influence of cattle breeds on the plasma kinetics of moxidectin (MXD) after topical (pour-on) administration. Parasite-free Aberdeen Angus and Holstein calves were treated with a commercial MXD pour-on formulation at 500 microg/kg. Blood samples were collected over a period of 35 days post-treatment and the recovered plasma was analysed by high performance liquid chromatography using fluorescence detection. MXD was detected in plasma from two hours up to 35 days post-treatment in animals from both breeds. A slow MXD absorption and delayed peak plasma concentration were observed in Aberdeen Angus compared to Holstein calves. Significant lower systemic availability (expressed as AUC) (P<0.01) and peak plasma concentration (C(max)) (P<0.05) were also observed in Aberdeen Angus calves, although the plasma mean residence time (MRT) and elimination half-lives (T(1/2el)) of MXD in both breeds were similar. The pharmacokinetic differences observed between cattle breeds contribute to explain the variability in the pattern of clinical efficacy for pour-on administered endectocide compounds reported in different field trials.