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A narrative review of the impact of work hours and insufficient rest on job performance
No full textObjective
This review discusses the scientific evidence regarding effects of insufficient rest on clinical performance and house officer training programs, the associations of clinical duty scheduling with insufficient rest, and the implications for risk management.
Study design
Narrative review.
Methods
Several literature searches using broad terms such as “sleep deprivation,” “veterinary,” “physician,” and “surgeon” were performed using PubMed and Google scholar.
Results
Sleep deprivation and insufficient rest have clear and deleterious effects on job performance, which in healthcare occupations impacts patient safety and practice function. The unique requirements of a career in veterinary surgery, which may include on-call shifts and overnight work, can lead to distinct sleep challenges and chronic insufficient rest with resultant serious but often poorly recognized impacts. These effects negatively impact practices, teams, surgeons, and patients. The self-assessment of fatigue and performance effect is demonstrably untrustworthy, reinforcing the need for institution-level protections. While the issues are complex and there is no one-size-fits-all approach, duty hour or workload restrictions may be an important first step in addressing these issues within veterinary surgery, as it has been in human medicine.
Conclusion
Systematic re-examination of cultural expectations and practice logistics are needed if improvement in working hours, clinician well-being, productivity, and patient safety are to occur.
Clinical significance (or Impact)
A more comprehensive understanding of the magnitude and consequence of sleep-related impairment better enables surgeons and hospital management to address systemic challenges in veterinary practice and training programs
Caudal peduncle mineralized lesion resembling calcinosis circumscripta in a wels catfish Silurus glanis
No full textThis report presents an intriguing case of a mineralized lesion resembling calcinosis circumscripta observed in the caudal peduncle of a wels catfish, housed in a public aquarium in northern Italy. The investigation encompasses a comprehensive analysis of various aspects, including clinical presentation, diagnostic imaging, as well as gross and microscopic pathology, and immunohistochemistry. Histopathology, in particular, highlighted a severe focally extensive granulomatous reaction, confirmed by dense histiocytic inflammatory infiltrates and the massive presence of multinucleated foreign body type giant cells localized around lakes and aggregates of mineralized material. Moreover, the usefulness and limitations of immunohistochemistry and special stains in characterizing fish tissues and cell types are highlighted. Although reported in elasmobranchs and sturgeons, to our knowledge, this is the first description of calcinosis circumscripta in teleost fish and it offers valuable insights into the understanding of similar pathologies in aquatic organisms
Modulation of in vitro SARS-CoV-2 infection by stephania tetrandra and its alkaloid constituents
No full textBotanical natural products have been widely consumed for their purported usefulness against COVID-19. Here, six botanical species from multiple sources and 173 isolated natural product compounds were screened for blockade of wild-type (WT) SARS-CoV-2 infection in human 293T epithelial cells overexpressing ACE-2 and TMPRSS2 protease (293TAT). Antiviral activity was demonstrated by an extract from Stephania tetrandra. Extract fractionation, liquid chromatography–mass spectrometry (LC-MS), antiviral assays, and computational analyses revealed that the alkaloid fraction and purified alkaloids tetrandrine, fangchinoline, and cepharanthine inhibited WT SARS-CoV-2 infection. The alkaloids and alkaloid fraction also inhibited the delta variant of concern but not WT SARS-CoV-2 in VeroAT cells. Membrane permeability assays demonstrate that the alkaloids are biologically available, although fangchinoline showed lower permeability than tetrandrine. At high concentrations, the extract, alkaloid fractions, and pure alkaloids induced phospholipidosis in 293TAT cells and less so in VeroAT cells. Gene expression profiling during virus infection suggested that alkaloid fraction and tetrandrine displayed similar effects on cellular gene expression and pathways, while fangchinoline showed distinct effects on cells. Our study demonstrates a multifaceted approach to systematically investigate the diverse activities conferred by complex botanical mixtures, their cell-context specificity, and their pleiotropic effects on biological systems
Characterization of neurotropic HPAI H5N1 viruses with novel genome constellations and mammalian adaptive mutations in free-living mesocarnivores in Canada
No full textThe GsGd lineage (A/goose/Guangdong/1/1996) H5N1 virus was introduced to Canada in 2021/2022 through the Atlantic and East Asia-Australasia/Pacific flyways by migratory birds. This was followed by unprecedented outbreaks affecting domestic and wild birds, with spillover into other animals. Here, we report sporadic cases of H5N1 in 40 free-living mesocarnivore species such as red foxes, striped skunks, and mink in Canada. The clinical presentations of the disease in mesocarnivores were consistent with central nervous system infection. This was supported by the presence of microscopic lesions and the presence of abundant IAV antigen by immunohistochemistry. Some red foxes that survived clinical infection developed anti-H5N1 antibodies. Phylogenetically, the H5N1 viruses from the mesocarnivore species belonged to clade 2.3.4.4b and had four different genome constellation patterns. The first group of viruses had wholly Eurasian (EA) genome segments. The other three groups were reassortant viruses containing genome segments derived from both North American (NAm) and EA influenza A viruses. Almost 17 percent of the H5N1 viruses had mammalian adaptive mutations (E627 K, E627V and D701N) in the polymerase basic protein 2 (PB2) subunit of the RNA polymerase complex. Other mutations that may favour adaptation to mammalian hosts were also present in other internal gene segments. The detection of these critical mutations in a large number of mammals within short duration after virus introduction inevitably highlights the need for continually monitoring and assessing mammalian-origin H5N1 clade 2.3.4.4b viruses for adaptive mutations, which potentially can facilitate virus replication, horizontal transmission and posing pandemic risks for humans.Canadian Food Inspection Agency emergency funding for 2022 AIV outbreak
A narrative review of the pathophysiology and impacts of insufficient and disrupted sleep.
No full textBackground Despite substantial ramifications of insufficient sleep on mental and physical health and general well-being, many individuals are unaware of what constitutes sufficient sleep, or of the short- and long-term extent of sleep deficiency effects, including those that may not be perceived as fatigue.
Objectives and procedures This review describes the physiology of sleep, defines healthy standards, reviews the pathophysiology and health hazards of acute and chronic sleep insufficiency, and offers concepts for improving individual sleep hygiene. Online databases were searched to extract literature pertaining to sleep, sleep insufficiency, fatigue, and health, with emphasis on literature published in the preceding 5 years.
Results The detrimental effects of acute and chronic sleep loss vary in their range and impact. Individuals often obtain a substandard quantity of sleep, a problem that is poorly recognized by individuals and society. This lack of recognition perpetuates a culture in which sleep insufficiency is accepted, resulting in serious and substantial negative impacts on mental and physical health.
Conclusion and clinical relevance Sleep management is one of the most fundamental and changeable aspects of personal health. Improving awareness of the important physiological roles of sleep, healthy sleep habits, and the consequence of insufficient sleep is essential in promoting general well-being and mental and physical health.journal articlereview2023 Junimporte
A deep learning LSTM approach to predict COVD-19 deaths in North Africa
No full textThe countries of Tunisia, Algeria, and Morocco are part of the North Africa region, also called the Maghreb. As of October 16, 2022, there are 52413 COVID-19 related deaths reported for these countries despite the significant progress in vaccination.1 A notable interest by scholars has emerged recently to model and to forecast the spread and the lethality of the pandemic and its impact in the Middle East and North Africa region. In a recent study, spatial panel-data models were used to identify the factors for the spike of COVID-19 infections in North Africa.2 In another study, a statistical analysis was performed based on zero-inflation models and autoregressive conditional count models to forecast death counts with evidence from Tunisian data.3 Furthermore, quantitative analyses including statistical modeling and deep learning methods have also been performed to forecast the pandemic outbreak in different parts of the world.4 For instance, some authors presented long short-term memory (LSTM) based models to predict novel infections of the coronavirus in India, whereas in other studies deep learning methods were used to forecast new COVID-19 cases and death rates in Australia and Iran.5 Using COVID-19 datasets of several countries including Brazil, Germany, Italy, Spain, United Kingdom, China, India, Israel, Russia, and United States, alternative deep learning methods were studied and their results were compared in terms of forecast performance.6 In this study, we contribute to this ongoing literature, by conducting a statistical analysis with publicly available data on the coronavirus death counts for the Maghreb countries, and we show that the method of deep learning with LSTM network outperforms time series autoregressive integrated moving average (ARIMA) models in terms of forecast accuracy for the pandemic deaths
Mechanisms accounting for gendered differences in mental health status among young Canadians: A novel quantitative analysis
No full textAdolescent girls consistently report worse mental health than boys. This study used reports from a 2018 national health promotion survey (n = 11,373) to quantitatively explore why such gender-based differences exist among young Canadians.
Using mediation analyses and contemporary social theory, we explored mechanisms that may explain differences in mental health between adolescents who identify as boys versus girls. The potential mediators tested were social supports within family and friends, engagement in addictive social media use, and overt risk-taking. Analyses were performed with the full sample and in specific high-risk groups, such as adolescents who report lower family affluence.
Higher levels of addictive social media use and lower perceived levels of family support among girls mediated a significant proportion of the difference between boys and girls for each of the three mental health outcomes (depressive symptoms, frequent health complaints, and diagnosis of mental illness). Observed mediation effects were similar in high-risk subgroups; however, among those with low affluence, effects of family support were somewhat more pronounced.
Study findings point to deeper, root causes of gender-based mental health inequalities that emerge during childhood. Interventions designed to reduce girls' addictive social media use or increase their perceived family support, to be more in line with their male peers, could help to reduce differences in mental health between boys and girls. Contemporary focus on social media use and social supports among girls, especially those with low affluence, warrant study as the basis for public health and clinical interventions.Canadian Institutes of Health Research GrantPublic Health Agency of Canad
Effects of changing veterinary handling techniques on canine behaviour and physiology
No full textVeterinary care can be a source of fear and stress for canine patients, negatively affecting their welfare, health, and quality of care received. Low-stress handling has become more popular, but it is not standardized and is largely untested. The primary aim of this project was to determine if changes in veterinary handling techniques—with an emphasis on collaborative, adaptive care where the patient is an active participant—would affect the level of distress for canine patients during veterinary visits. Twenty-eight dogs underwent 4 visits across 8 weeks. Owners completed the Working Dog Questionnaire Pet version (WDQ-Pet), collecting demographic, environmental, and training history, for each dog. During each visit the dogs were weighed, received a standardized physical exam, and had a blood sample obtained. All participants received the same care during the first visit and were then randomized into either the control or intervention group for visits 2-4. The 14 dogs in the intervention group underwent procedures designed to reduce stress and to encourage their collaboration during examination. In the control group, 14 dogs received routine care with no interventions. Chapter 1 provides a review of the current literature that has assessed low-stress intervention techniques and collaborative care during veterinary visits. Chapter 2 focuses on the physiological measurements and results (heart rate (HR), serum cortisol (CORT), creatine kinase (CK), and neutrophil/lymphocyte ratio (NLRs)) measured at each visit. There were no differences between the groups in HR, NLR, and CK measurements, and both had a reduction of CORT across all visits. However, in the intervention group there was a significantly greater reduction in CORT when visit 4 was compared with visit 1 (Wilcoxon Mann–Whitney test: Z = 1.75; p = 0.04). A composite stress score index was formulated based on the summed standardized scores for the physiological parameters. This index was significantly different for the intervention (paired t-tests: t-value = 2.37; p = 0.027) but not control group (t-value = −1.12; p = 0.29) when visits 1 and 4 were compared. Within the control group there was a tendency for the stress index to worsen at visit 4 compared to visit 1. In chapter 3, the behavioural results using in-person and via video scoring and information from the WDQ-Pet are discussed. Within the 58 assessment categories of the WDQ-Pet only two categories significantly differed between the control and intervention groups. Video and in-person evaluations were conducted when dogs first entered the hospital, were weighed, entered the exam room, at the beginning and end of the exam, and after venipuncture. There was no difference in scores between the intervention and control groups when walking into the hospital or into the exam room, and most dogs had low scores. At visit 4, dogs in the intervention group had a considerably lower score when weighed (1-tailed t-test; t (26) = 2.087; p = 0.023). Additionally, when assessing scores at the start and end of the physical exam, there was a significant difference between the behaviour of the intervention and control group across visits 1 and 4 (Start of exam: 2(1, n = 28) = 5.60, p = 0.018; End of exam: 2 (1, n = 28) = 7.036, p = 0.0080). The combined data indicate that when practical patient-centered changes are made during visits, they can have a profound effect on the reduction of fear and stress, and improve the overall patient experience during veterinary visits
Conversation at the crossroads: Exploring the talk-in-interaction of teachers in a French language minority school in a time of demographic change
No full textThis doctoral thesis examines how teachers construct themselves as teachers in a French language minority school (FMS), how they construct their school, language and culture, and their students. In the present study, teachers are categorized as "French teachers" based on their employment in a FMS, regardless of the subjects they teach. Drawing on critical theory and critical applied linguistics, and theories of re/production and resistance, the study investigates the interplay between language and power dynamics, using the methodologies of ethnomethodology, conversation analysis, and membership categorization analysis. For data collection, the study uses the focus group interview as a social practice and therefore as a site of investigation where meaning is collaboratively produced through talk-in-interaction. The participants used language to perpetuate or challenge dominant school cultural norms and ideologies. They represented the French language as a noble cause, and used methods such as binaries, categorization, category contrasts, and the dual mandate of the school district, as well as humour, deflection, and avoidance. The study found that the participants oriented to themselves as language and culture agents in the service of "making a difference" and as contributors to the preservation of the Francophone/Acadian community. At times, they constructed new cultural and linguistic groups as potentially posing a threat to the Acadian culture and people. The study acknowledges that the participants' ideology of ethnonationalism presents a significant challenge for the inclusion of culturally and linguistically diverse immigrant and newcomer students who were viewed as potentially threatening the unique and distinct characteristics of the French language and the survival of the Acadian culture. The study suggests potential ways to foster inclusive discourse and practice in FMSs and calls for further research
Building capacity with evaluation standards and guidelines in Prince Edward Island: Responding to academics’ “Call to Action”
No full textThe purpose of this practice note is to promote knowledge sharing and insight for evaluation practitioners and academics in other jurisdictions by reflecting on evaluation policy development in Prince Edward Island. The author describes the process of developing evaluation standards and guidelines for the Government of Prince Edward Island and the benefits of a systematic development process. The author reviews each phase of the process, including “Identify,” “Consult,” “Study,” “Consensus,” “External Review,” and “Endorsement.” The author concludes that the benefit of developing evaluation standards and guidelines is two-fold: A new resource is added to the government’s evaluation toolkit, and the development process provides an opportunity for capacity and interdepartmental community building.
Le but de cette note de pratique est de promouvoir le partage des connaissances et des idées pour les praticiens de l’évaluation et les universitaires d’autres juridictions en réfléchissant à l’élaboration de politiques d’évaluation à l’Île-du-Prince-Édouard. Je décris le processus d’élaboration de normes et de lignes directrices d’évaluation pour le gouvernement de l’Île-du-Prince-Édouard et les avantages d’un processus d’élaboration systématique. J’examine chaque phase du processus, y compris « Identifier », « Consulter », « Étudier », « Consensus », « Examen externe » et « Approbation ». Je conclus que l’avantage de l’élaboration de normes et de lignes directrices en matière d’évaluation est double : une nouvelle ressource est ajoutée à la boîte à outils d’évaluation du gouvernement et le processus de développement offre une opportunité de renforcement des capacités et de la communauté interministérielle