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Many Rangifer tarandus (caribou or reindeer) populations across North America have been declining, posing a variety of challenges for Indigenous communities that depend on the species for physical and cultural sustenance. This article used a scoping review methodology to systematically examine and characterize the nature, extent, and range of articles published in academic journals on the connection between Rangifer and Indigenous well-being in the Arctic and Subarctic regions of North America. Two reviewers independently used eligibility criteria to identify and screen abstracts and titles and then screen full texts of each potentially relevant article. To be included in this review, articles had to discuss linkages between Rangifer and Indigenous well-being in the North American Arctic and Subarctic and be published prior to 2018. A total of 4279 articles were identified and screened for relevance; 58 articles met the inclusion criteria and were analyzed using descriptive quantitative and thematic qualitative methods. Results characterized the depth and diversity of what we know about Rangifer for Indigenous culture, food security, livelihoods, psychological well-being, and social connections across North America in the academic literature. Several gaps were identified. Little is known about the psychological ties between Rangifer and Indigenous Peoples and the influence of Rangifer-related change on Indigenous well-being and adaptive capacity. We urgently need to know more about the emotional connections that arise from Indigenous-Rangifer linkages, the effectiveness of adaptive strategies, and the intergenerational implications of Rangifer-related change. Further, enhanced inclusion of Indigenous Peoples in the production of knowledge on this topic is fundamental to the future of understanding Indigenous-Rangifer relationships.

In this article, we present a case study of sewing as a strategy for arts-based inquiry in health research, situated within a broader project that highlighted Nunavut Inuit women’s childbirth experiences. Five focus groups were hosted as sewing sessions with pregnant women ( N = 19) in Iqaluit, Nunavut (2017–2018). Women’s reflections on the sessions, and the significance of sewing to Inuit, were integrated with researchers’ critical reflections to examine the value of sewing as a strategy for arts-based inquiry within a focus group method: results related to the flexibility of the sessions; how collective sewing created space for voicing, sharing, and relating; sewing as a tactile and place-specific practice tied to Inuit knowledge and tradition; and lessons learned. Our results underscore the possibilities of arts-based approaches, such as sewing, to enhance data gathering within a focus group method and to contribute to more locally appropriate, place-based methods for Indigenous health research.

Background Cats, being obligate carnivores, have unique dietary requirements for nutrients most commonly found in dietary ingredients of animal origin. As such, feeding a diet devoid of animal-derived ingredients has been postulated as a possible cause of nutrient imbalances and adverse health outcomes. A small proportion of cat owners feed strictly plant-based diets to the cats in their care, yet the health and wellness of cats fed these diets has not been well documented. Results A total of 1325 questionnaires were complete enough for inclusion. The only exclusion criterion was failure to answer all questions. Most cats, 65% (667/1026), represented in the survey were fed a meat-based diet and 18.2% (187/1026) were fed a plant-based diet, with the rest fed either a combination of plant-based with meat-based (69/1026, 6.7%) or indeterminable (103/1026, 10%). Cat age ranged from 4 months to 23 years, with a median of 7 years, and was not associated with diet type. No differences in reported lifespan were detected between diet types. Fewer cats fed plant-based diets reported to have gastrointestinal and hepatic disorders. Cats fed plant-based diets were reported to have more ideal body condition scores than cats fed a meat-based diet. More owners of cats fed plant-based diets reported their cat to be in very good health. Conclusions Cat owner perception of the health and wellness of cats does not appear to be adversely affected by being fed a plant-based diet. Contrary to expectations, owners perceived no body system or disorder to be at particular risk when feeding a plant-based diet to cats. This study collected information from cat owners and is subject to bias, as well as methodological limitations. Further research is warranted to determine if these results are replicable in a prospective investigation.

OBJECTIVE To evaluate the influence of owner presence on behavioral and physiologic indicators of fear in dogs during routine physical examinations. ANIMALS 32 client-owned dogs. PROCEDURES Dogs underwent a standardized, video-recorded examination consisting of 6 phases (examination of the head, lymph node palpation, body palpation, axillary temperature measurement, heart rate assessment, and respiratory rate assessment) with or without their owner present in a randomized, controlled study. Behaviors reported to be indicative of fear, including reduced posture, avoidance, escape, lip licking, body shaking, yawning, and vocalizing, were assessed during each phase, and physiologic measurements were assessed during relevant phases by the investigator. Owner presence and sex and age of dogs were investigated for associations with behavioral signs of fear; behavioral and physiologic measurements were compared between groups (owner present vs owner absent). RESULTS Dogs in the owner-present group had a lower rate of vocalizations, lower mean axillary temperature, and higher rate of yawning than dogs in the owner-absent group. Female dogs in the owner-absent group had a higher heart rate than females and males in the owner-present group and males in the owner-absent group, and the rate of lip licking decreased as age increased in the owner-present group. The presence of reduced body posture and rates of lip licking, avoidance behavior, and escape behavior were associated with examination phase. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that, when practical, owners should be encouraged to remain with their dog during routine veterinary examinations. However, effects of owner presence during procedures require further investigation. (J Am Vet Med Assoc 2020;257:1031–1040)

OBJECTIVE To assess handling techniques commonly used during routine examinations and procedures used for calm, fearful, and aggressive cats by veterinarians and nonveterinarian staff at Canadian and US veterinary practices and to evaluate demographic factors associated with those handling techniques. SAMPLE 310 veterinarians and 944 nonveterinarians who handle cats at Canadian and US veterinary practices. PROCEDURES An online questionnaire was developed to evaluate respondent demographics and use of common cat handling practices and techniques. A snowball sampling method was used to send a link to the questionnaire to members of Canadian and US veterinary-affiliated groups. Descriptive statistics were generated; logistic regression was used to identify demographic factors associated with the use of minimal and full-body restraint with scruffing during routine examination and procedures for fearful and aggressive cats. RESULTS Full-body restraint was used to handle cats of all demeanors, although its frequency of use was greatest for fearful and aggressive cats. Veterinarians and nonveterinarians who graduated from veterinary training programs before 2006 were less likely to use full-body restraint for cats of all demeanors, compared with nonveterinarians who did not graduate or graduated between 2006 and 2015. Other factors associated with decreased use of full-body restraint included working at an American Association of Feline Practitioners-certified practice and working at a Canadian practice. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that full-body restraint is commonly used to handle cats. Further research is necessary to determine whether current handling recommendations are effective in decreasing stress for cats during veterinary visits.

BackgroundThe double burden of malnutrition is the co-occurrence of undernutrition (e.g. underweight, stunting, and micronutrient deficiencies) and over-nutrition (e.g. obesity, type 2 diabetes, and cardiovascular disease) at the population, household, or individual level. The objectives of this study were to determine the extent and determinants of individual-level co-morbid anemia and overweight and co-morbid anemia and diabetes in a population in rural Tamil Nadu, South India.MethodsWe undertook a cross-sectional study of adults (n = 753) in a rural region of Tamil Nadu, South India. A survey assessed socio-demographic factors, physical activity levels, and dietary intake. Clinical measurements included body-mass index, an oral glucose tolerance test, and blood hemoglobin assessments. Multivariable logistic regression analyses were used to determine associations between risk factors and two co-morbid double burden pairings: (1) anemia and overweight, and (2) anemia and diabetes.ResultsPrevalence of co-morbid anemia and overweight was 23.1% among women and 13.1% among men. Prevalence of co-morbid anemia and diabetes was 6.2% among women and 6.3% among men. The following variables were associated with co-morbid anemia and overweight in multivariable models [odds ratio (95% confidence interval)]: female sex [2.3 (1.4, 3.85)], high caste [3.2 (1.34, 7.49)], wealth index [1.1 (1.00, 1.12)], rurality (0.7 [0.56, 0.85]), tobacco consumption [0.6 (0.32, 0.96)], livestock ownership [0.5 (0.29, 0.89)], and energy-adjusted meat intake [1.8 (0.61, 0.94)]. The following variables were associated with co-morbid anemia and diabetes in multivariable models: age [1.1 (1.05, 1.11)], rurality [0.8 (0.57, 0.98)], and family history of diabetes [4.9 (1.86, 12.70).ConclusionThis study determined the prevalence and factors associated with individual-level double burden of malnutrition. Women in rural regions of India may be particularly vulnerable to individual-level double burden of malnutrition and should be a target population for any nutrition interventions to address simultaneous over- and undernutrition.

Veterinarians play a critical role in providing nutrition consultation and supporting clients to adopt healthy dietary habits for their pets; thus applicable, informative nutrition education in veterinary schools is essential. The aim of this study was to explore incoming veterinary students’ perceived importance, emphasis, and confidence in the veterinary nutrition education they will receive. First-year veterinary students at all 5 Canadian and 5 randomly selected US veterinary schools were invited to complete a 31-item questionnaire. Response rate was 34.6% (n = 326). Descriptive statistics and multivariate logistic regression were performed. While most students (92%) considered nutrition education to be an important component of veterinary training, 64% felt it will not be a subject of great emphasis. Veterinary students at schools with a board-certified veterinary nutrition faculty were more likely to perceive higher emphasis on nutrition education (p

BACKGROUND Communication practices used by veterinarians can impact client's involvement in decision-making. The objective of this study was to evaluate the level of client involvement in veterinary care decisions and factors impacting client involvement. METHODS A random sample of practising companion animal veterinarians and a convenience sample of pet owners were recruited. Each consultation was audio-video recorded and analyzed using the Observer OPTION5 instrument, adapted from human medicine, to assess veterinarians' level of shared decision-making. A mixed linear model was used to assess statistical associations between veterinarian, client and appointment-level factors and OPTION5 scores. RESULTS Sixty veterinarians and 909 of their clients were audio-video recorded during a consultation, of which 717 interactions included a decision identified for analysis using the OPTION5 instrument. Elements consistent with shared decision-making were uncommon, with a mean OPTION5 score of 22.6 (median = 20.0; sd = 13.05; range = 0-75) out of 100. OPTION5 scores were positively associated with the length of the appointment and negatively associated with the veterinarian's years in practice when controlling for statistical interaction between client income and appointment type. CONCLUSION Findings suggest an opportunity exists for veterinarians to incorporate more client involvement through increased use of shared decisionmaking behaviours during veterinary consultations.

Jurisdictions around the world have implemented indoor tanning legislations, which aim to protect all individuals, especially youth, from dangers of artificial ultraviolet radiation exposure. The objective of this study was to conduct a systematic review to synthesize the available peer-reviewed literature to determine whether indoor tanning legislation has impacted the prevalence of youth indoor tanning. Following PRISMA guidelines, six databases were searched in 2016. Reference lists from relevant articles were also searched. An updated literature search was conducted in 2018. Each article was critically appraised using a merged checklist created from two previously validated checklists. All articles meeting the inclusion criteria were retained after appraisal. Seven studies, all conducted in the U.S., met the inclusion criteria. All studies used an observational, cross-sectional design. There were small absolute decreases in youth indoor tanning prevalence after legislation vs before (n = 3, mean = 3% decrease, range = 1%–6% decrease). Prevalence of youth indoor tanning was significantly lower in states with indoor tanning legislation vs states without legislation (n = 4, mean = 5% lower, range = 1%–18% lower). Prevalence of youth indoor tanning was lower in states with longer standing indoor tanning legislation vs states with more recently implemented legislation (n = 2, mean = 9% lower, range = 2%–20% lower). Indoor tanning legislation is generally associated with lower indoor tanning prevalence among youth. The small percent differences equate to millions of youth at the population level. Longer time lapses from legislation implementation to evaluation, coupled with greater enforcement, compliance, legislative stringency, and public education may result in even more pronounced declines in youth indoor tanning prevalence.

Veterinary visits result in behavioural and physiological signs of fear and stress for many companion dogs. There are a number of factors that likely contribute to this response, but little is known about possible effects of the acoustic environment. The aim of this study was to assess the effect of elevated levels of common veterinary background noises on fear-related responses in dogs during a routine physical examination in a veterinary setting. Testing took place in an examination room at a veterinary clinic and involved 33 owned companion dogs. All dogs received a standardized physical examination where each dog was either presented with no additional noise (n = 16, control), or a pre-recorded noise track that included the sounds of people talking, dogs barking, and metal doors clanging (n = 17). This noise track was played back with a peak sound level of 68.0 dB, which is comparable to levels previously recorded in clinic settings. The dogs’ behavioural responses (lip licking, yawning, reduced posture, avoidance, vocalizing, trembling) were scored from video by a blinded observer for each stage of the physical examination (i.e., head exam, lymph node palpation, body palpation, temperature assessment, heart rate assessment, and respiratory rate assessment). In addition, willingness to approach the examiner was assessed before and after the examination. For behavioural measures, generalized mixed models and Fisher’s exact tests were used to assess the effects of noise, exam phase, sex, and age, with dog as a random effect. For temperature, a general linear model was used to assess the effects of noise, sex, and age, and the remaining physiological measures were assessed using t-tests. Only respiratory rate was increased with exposure to background noise (F1,31 = 6.74, p = 0.0143); no other responses were affected. However, lip licking (F5,65 = 4.04, p = 0.003), avoidance (F5,158 = 6.36, p

There is a need to further understand companion-animal relinquishment in order to prevent it. This study explored published reviews and commentaries, written by primary stakeholders, on companion-animal relinquishment, including 77 reviews and commentaries published between 1973 and 2011. The analysis-method framework is conducive to analyzing reviews and commentaries on a complex social phenomenon such as companion-animal relinquishment. Four themes emerged: identified reasons caretakers relinquish, solutions to relinquishment, euthanasia as an outcome of relinquishment, and the role of research in addressing relinquishment. Research-based views about reasons for relinquishment were most commonly discussed. Only a few research articles were cited, highlighting the impact of these few studies on stakeholders’ perceptions. The predominant solution discussed was education, while future research suggestions focused on investigating interventions. Findings provide insight into the influences on stakeholders’ views, including their use and interpretation of existing research.

Evidence of the dangers of indoor tanning and its popularity, including among youth, led the Government of Ontario to pass the Skin Cancer Prevention Act (Tanning Beds) (SCPA) in 2014. This legislation includes prohibiting the sale of indoor tanning services to individuals under 18, requiring warning signs be posted, and other safety regulations. We collected information from Ontario Public Health Units to conduct a process evaluation of the SCPA to: understand legislation implementation; assess available evidence about compliance, inspection, and enforcement; and, note barriers and facilitators related to inspection and enforcement. Data was collected March-April 2018. All 36 Ontario Public Health Units were invited to participate in an online questionnaire about the SCPA. Questions covered complaints, inspection, and enforcement, and used both close- and open-ended questions. Participants from 20 Public Health Units responded to the questionnaire; a response rate of 56%. These agencies reported 485 facilities offer indoor tanning. Since 2014, there have been 242 infractions by tanning facility owner/operators related to the SCPA, with most being uncovered during non-mandatory routine inspections (n = 234, 97%), rather than mandatory complaint-based inspections (n = 8, 3%). Most infractions were related to warning signs (n = 201, 83%). No charges were issued for any infractions. Instead, providing education (n = 90, 62%) and issuing warnings (n = 33, 23%) were the most common enforcement strategies. SCPA amendments are needed, including mandatory, routinely scheduled inspections. In addition to providing education, fines may improve compliance. More resources are required for inspection and enforcement of the SCPA.

Owned, shelter, and laboratory cats undergo handling and restraint throughout their lifetime for routine health examinations and necessary procedures. Many cats display fear and aggressive behaviour during health examinations, and there is potential for these behaviours to result in incomplete examination, and inadequate diagnosis and treatment, which are cat welfare concerns. Given the lack of validated methods to assess cat responses to restraint, the current study aimed to validate two behavioural paradigms: 1) a Handler Aversion Test, and 2) a Conditioned Place Aversion (CPA) test, to assess aversion response differences between passive restraint (the control) and full-body restraint (known to be negative). Cats were initially assessed as either friendly or unfriendly during interactions with a stranger, and this was included as a covariate in analyses. During the Handler Aversion Test, cats were restrained with the passive (n = 20) or full-body (n = 18) restraint, and aversion was assessed by measuring cat latency to approach the handler. CPA testing was carried out separately in laboratory (n = 10) and shelter (n = 42) cats using an apparatus made up of two visually-distinct compartments: cats were handled with passive restraint on one side, and full-body restraint on the other side, with handling methods counter-balanced between compartments. After handling, cats were placed into the apparatus and dwelling time was assessed for each compartment. For the Handler Aversion Test, only 38 out of 51 cats could be trained to walk the required runway, and latency to approach the handler was not significantly different between treatments (P > 0.1). During CPA testing, laboratory cats and friendly shelter cats showed aversion towards the full-body restraint compartment, spending most of their time in the passive compartment (P = 0.043, P = 0.035, respectively); a result not seen in unfriendly shelter cats. The current results suggest that, as assessed in the current study, the CPA test is more sensitive than the Handler Aversion Test for detecting differences in cat aversion responses between a known negative and control restraint technique.

The overall objective of this study was to describe the contact structure and animal movement patterns of porcine epidemic diarrhea (PED) case herds and matched control herds during the initial incursion of PEDV in Canada, and to evaluate possible mechanisms of spread during this period. Possible mechanisms of spread included transmission through a common-source, herd-to-herd transmission, and transmission due to low biosecurity. Three hypotheses were evaluated by assessing: 1) whether feed supplier, semen supplier and/or animal transportation company networks contained a higher proportion of case herds compared to randomly permuted networks, 2) whether the proportion of case herds in the giant weak component differed from randomly permuted networks, and 3) whether external herd biosecurity, defined as the number of mean contacts with other herds in a one-mode network, was different between case and control herds. The study period for recruiting case and control herds was from January 22, 2014 to March 1, 2014, and a 30-day history of each participating site was collected using a questionnaire. The study included swine herds located in central and eastern Canadian provinces. Multiple two-mode networks with swine herds and service suppliers were constructed. This included feed suppliers, animal movement, animal transportation companies, semen suppliers and a complete network with all service providers. The complete network consisted of 145 nodes. There were a total of 765 edges in the complete network and majority were between feed suppliers and primary herds 29.8% (228/765). The proportion of case herds in the largest feed supplier network was higher than what was expected using randomly permuted networks, suggesting that the likely mechanism of spread during this phase was a common-source through the feed network. A single feed supplier (FS1) had the highest out-degree and outgoing contact chain indicating its importance in disease spread throughout the feed and complete networks. Network descriptive measures, as well as the results of the hypotheses testing indicate little significance in the roles of animal movement, animal transportation companies, and semen suppliers during the initial phase of the 2014 Canadian PED outbreak.

With the widespread use of digital media as a tool for documentation, creation, preservation, and sharing of audio-visual content, new strategies are required to deal with this type of “data” for research and analysis purposes. This article describes and advances the methodological process of using documentary film as a strategy for qualitative inquiry. Insights are drawn from a multimedia study that explored Inuit-caribou relationships in Labrador, Canada, through the co-production of community-based, research-oriented, participatory documentary film work. Specifically, we outline: 1) the influence of documentary film on supporting the project conceptualization and collaboration with diverse groups of people; 2) the strength of conducting filmed interviews for in-depth data collection, while recognizing how place and activities are intimately connected to participant perspectives; and 3) a new and innovative analytical approach that uses video software to examine qualitative data, keep participants connected to their knowledge, and simultaneously work toward creating high impact storytelling outputs. The flexibility and capacity of documentary film to mobilize knowledge and intentionally create research outputs for specific target audiences is also discussed. Continued and future integration of documentary film into qualitative research is recommended for creatively enhancing our abilities to not only produce strong, rich, and dynamic research outputs, but also simultaneously to explore and communicate diverse knowledges, experiences, and stories.

Some dog owners elect to feed their dog a plant-based food either as part of or for their entire dietary intake. Being omnivores or facultative carnivores, a strictly plant-based diet is not the natural type of food dogs evolved to consume, leaving some question as to whether this feeding management strategy is safe and healthy for dogs.This study surveyed owner perceptions of health and wellbeing of dogs and compared between those fed meat-based and plant-based diets.A web-based questionnaire was distributed to pet owners to collect data on dog characteristics, husbandry, health and wellbeing. Univariate comparisons between diet groups was made by chi square analyses or Kaplan-Meier tests as appropriate, with a significance cut-off value of 0.05. Multivariate models were negative binomial and logistic regression for count and categorical data, respectively.Owners feeding plant-based diets to their dog reported fewer health disorders, specifically with respect to ocular or gastrointestinal and hepatic disorders. Dog longevity was reported to be greater for dogs fed plant-based diets. Owners feeding plant-based diets to their dogs relied less on veterinary associates for nutrition information, versus dog owners feeding meat-based diets.Dog owners feeding a plant-based diet did not perceive adverse health effects in their dogs. The results might suggest an association between feeding a plant-based diet and perceived health and longevity, however inherent bias and limitations associated with surveys of owner perception must be considered, and objective research is required to determine if plant-based diets truly affect canine health.

Background: This study aimed to investigate the overall awareness of type 2 diabetes as well as how sociodemographic factors influence diabetes knowledge. With India having the second highest prevalence of diabetes globally, it is increasingly important to assess how diabetes can be addressed in rural Indian populations. Methods: Systematic random sampling was used to gather study participants in 17 villages within the Krishnagiri district of Tamil Nadu, India. Associations between sociodemographic factors and composite diabetes knowledge score were assessed using a multinomial logistic gllamm model.Results: A total of 753 individuals participated in the study. Overall knowledge on diabetes was low, with 66% of individuals having no knowledge regarding diabetes. Achieving a moderate knowledge score was significantly positively associated with education, wealth, participation in MGNREGA (Mahatma Gandhi National Rural Employment Guarantee Act), and business ownership as a source of income. Achieving a good knowledge score was significantly positively associated with education, wealth, rurality, participation in MGNREGA, business ownership as a source of income, as well as frequency of healthcare typically received. Rurality was significantly negatively associated [Relative Risk Ratio (95% CI)] with both moderate knowledge score [0.34 (0.19, 0.59)], and good knowledge score [0.43 (0.24, 0.74)]. The strongest predictor of having a good knowledge score was having a high school graduate or post-secondary education [11.07 (4.44, 27.61)]. Enrolment in MGNREGA employment was the strongest predictor for having a moderate knowledge score [3.27 (1.93, 5.54)], as well as strongly associated with having a good knowledge score [2.39 (1.31, 4.36)].Conclusion: The low awareness of diabetes seen in this study raises serious concerns for public health in India. Public health efforts must prioritize health equity to lessen the impacts of diabetes in rural populations, where individuals face systemic barriers to receiving prevention and treatment for conditions such as diabetes.

BACKGROUND Blood tests play a vital role in veterinary medicine, as they enable veterinarians to make decisions about their patients' medical care and provide opportunities to engage clients in veterinary care. The objective of this study was to explore perspectives of veterinary clients and veterinarians on current reporting practices for blood tests ordered in companion animal practice. The type of information communicated and client information seeking behaviours were examined. METHODS Two online surveys were distributed using snowball sampling: one targeting veterinary clients and one targeting veterinarians. RESULTS In total, 529 veterinary client and 416 veterinarian surveys were included in analyses. Significant differences were found between what blood test information veterinarian respondents felt they provided clients and what client respondents perceived they received with regard to their pet's blood tests. Almost 60% of clients somewhat or strongly agreed that they search the Internet if they do not understand why a test was ordered or what the results mean. Half of clients reported that they never receive a written report of their pet's blood work, 81% of whom were interested in receiving a copy. CONCLUSION Results of this research demonstrate opportunities to improve veterinarians' and clients' communication about blood tests.

One of the most complex aspects of the veterinarian-client-patient interaction is the clinical decision-making process. Research suggests that the approach to communication used by veterinarians can impact veterinary clients’ involvement in the decision-making process and their ultimate satisfaction. Using different approaches to the decision-making process may affect how information is exchanged and consequently how decisions are made. The objective of this study was to determine pet owners’ expectations with respect to information exchange and decision-making during veterinarian-client-patient interactions and to compare veterinarians’ perceptions of those expectations and the challenges they face in meeting them. Five pet owner focus groups (27 owners) and three veterinarian focus groups (24 veterinarians) were conducted with standardized open-ended questions and follow-up probes. Thematic analysis of the transcribed data was conducted to identify trends and patterns that emerged during the focus groups. Three pet owner-based themes were identified: 1) understanding the client; 2) providing information suitable for the client; and 3) decision-making. In addition, three barriers for veterinarians affecting information exchange and decision-making were identified: 1) time constraints; 2) involvement of multiple clients; and 3) language barriers. Results suggest that pet owners expect to be supported by their veterinarian to make informed decisions by understanding the client’s current knowledge, tailoring information and educating clients about their options. Breakdowns in the information exchange process can impact pet owners’ perceptions of veterinarians’ motivations. Pet owners’ emphasis on partnership suggests that a collaborative approach between veterinarians and clients may improve client satisfaction.

Objective: To explore pet owners’ online search experiences for pet health information and the perceived effects on their interactions and relationships with veterinarians. Background: Few studies have examined pet owners’ online searches for pet health information; even less is known about how these search experiences may impact pet owners’ interactions and relationships with veterinarians, including any effects on bond-centered care. Methods: Qualitative study consisting of five focus groups conducted with 26 pet owners in the Greater Toronto Area, Ontario, Canada, between June to September 2016. All interviews were audio-recorded and transcribed verbatim. QSR NVivo 11® was used to facilitate organisation of focus group data for thematic analysis. Results: Participating pet owners frequently referred to their relationships with veterinarians when discussing experiences searching online for pet health information. Owners reported choosing either to disclose or withhold declaring their online searches to veterinarians, depending on whether participants perceived a beneficial or detrimental impact on a “good” professional relationship with their veterinarian. Perceptions of veterinarians' reactions towards declaration of online searches were mixed, and influenced pet owners’ views of the existing relationship. Conclusion: Pet owners viewed their veterinarians as their most trusted source of pet health information, but many owners also wanted supplemental information from online searches. Owners preferred veterinarians refer them to online pet health resources, ideally those affiliated with the veterinary profession. Searching for pet health information online does not displace veterinarians’ guidance. Rather, the veterinarian-owner relationship was perceived to be strengthened when online searches were openly discussed with veterinarians. Implications: Findings offer insight into pet owners’ expectations of veterinarians within the context of online pet health information, providing ideas for veterinarians to strengthen bonds with owners such as; showing support of owners’ online pet health information searching by recommending resources and considerations about communicating professional opinions to owners regarding online information.

ObjectivesTo assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity.DesignRepeated cross-sectional.SettingBehavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand.ParticipantsEligible participants were self-identified men aged 16 years or older who reported sex with another man in the past 5 years. We classified 10 525 participants’ ethnicities: Asian (n=1003, 9.8%), Māori (Indigenous people of Aotearoa New Zealand, n=1058, 10.3%), Pacific (n=424, 4.1%) and European (n=7867, 76.8%).Outcome measuresThe sexual health outcomes examined were >20 recent (past 6 months) male sexual partners, past-year sexually transmitted infection (STI) testing, past-year STI diagnosis, lifetime and past-year HIV testing, lifetime HIV-positive diagnosis and any recent (past 6 months) condomless anal intercourse with casual or regular partners.ResultsWhen disaggregated, Indigenous and ethnic minority groups reported sexual health trends that diverged from the European MSM and each other. For example, Asian MSM increased lifetime HIV testing (adjusted OR, AOR=1.31 per survey cycle, 95% CI 1.17 to 1.47) and recent HIV testing (AOR=1.14, 95% CI 1.02 to 1.28) with no changes among Māori MSM or Pacific MSM. Condomless anal intercourse with casual partners increased among Māori MSM (AOR=1.13, 95% CI 1.01 to 1.28) with no changes for Asian or Pacific MSM. Condomless anal intercourse with regular partners decreased among Pacific MSM (AOR=0.83, 95% CI 0.69 to 0.99) with no changes for Asian or Māori MSM.ConclusionsPopulation-level trends were driven by European MSM, masking important differences for Indigenous and ethnic minority sub-groups. Surveillance data disaggregated by ethnicity highlight inequities in sexual health service access and prevention uptake. Future research should collect, analyse and report disaggregated data by ethnicity to advance health equity.

Extant research shows veterinarians face increasing challenges in discussing nutrition with clients despite receiving professional nutrition education in the veterinary medical curriculum. This article’s aim is to elicit student veterinarians’ baseline nutrition-related perceptions and nutrition information-seeking behaviors at the time of entering veterinary school. Participants were newly enrolled veterinary students at the Ontario Veterinary College ( n = 120). Focus group discussions ( n = 19) informed the design of an online questionnaire capturing students’ demographics and perceptions of their own and their pets’ nutrition. Students reported being influenced by individual factors (e.g., time), social networks (e.g., family), and surrounding environment (e.g., cost, contradictory media messages). Overall, 58% of students considered themselves knowledgeable about pet nutrition when commencing veterinary school, with 71% prioritizing their pets’ diets as much as their own. Students’ confidence in finding pet nutrition information was correlated with perceived accessibility ( r = .76, p = .001) and perceived quantity of information available on pet nutrition ( r = .83, p = .001), but not quality of information ( r = .13, p = .03). In general, students relied on and trusted veterinarians for nutrition advice. However, 94% of students mistrusted pet food companies’ motivations. Our data support that students entering veterinary school have their own perceptions on pet nutrition that impact nutrition education, suggesting this as an important consideration in the design and delivery of a veterinary nutrition curriculum. Veterinary medical faculty should be encouraged to discuss baseline nutrition information and address any misconceptions to prepare students for future consultations with clients.

Nunavut's maternal healthcare system is characterized by rapid transition from community-based birth to a practice of obstetric evacuation and institutionalized birth. Given calls for Inuit self-determination in research, maternal health research - which informs healthcare practices and policies - may need to be conducted differently, using different research methodologies, to include Inuit women's voices and lived experiences. In light of these calls, this article systematically synthesized the published maternal health literature in Nunavut and critically examined reported research methods. This systematic search and critical review involved a comprehensive database search and multi-level eligibility screening conducted by two independent reviewers. Data on the temporal, geographic, methodological, and topical range of studies were extracted, then descriptive statistics were calculated to summarize these data. A hybrid inductive and deductive qualitative analysis of the full-text articles was conducted to critically analyze research methodology. The initial search yielded 2656 distinct articles and twenty-eight articles met the inclusion criteria. These articles were published from 1975 to 2016, mostly used quantitative research methodology (71.4%), were written from clinical perspectives (57.1%), and focused on maternity care (53.6%). Emergent themes related to both the contributions and areas for growth of research methodology in the conceptualization, initiation, implementation, reporting, and knowledge mobilization stages of the research process. This review revealed opportunities for maternal health researchers to: redress the ongoing impacts of colonization; further include Inuit definitions of health and perspectives on birth in study designs; explore new methodologies that resonate with Inuit ways of knowing; continue (re)aligning research with community priorities; and move from consultation and collaborative partnership in research to Inuit leadership and data ownership. Indeed, this review illustrates that at each step of the research process, opportunity exists for Inuit perspectives and active involvement to shape and define maternal health research in Nunavut.

Background Race and ethnicity classification systems have considerable implications for public health, including the potential to reveal or mask inequities. Given increasing “super-diversity” and multiple racial/ethnic identities in many global settings, especially among younger generations, different ethnicity classification systems can underrepresent population heterogeneity and can misallocate and render invisible Indigenous people and ethnic minorities. We investigated three ethnicity classification methods and their relationship to sample size, socio-demographics and sexual health indicators. Methods We examined data from New Zealand’s HIV behavioural surveillance programme for men who have sex with men (MSM) in 2006, 2008, 2011, and 2014. Participation was voluntary, anonymous and self-completed; recruitment was via community venues and online. Ethnicity allowed for multiple responses; we investigated three methods of dealing with these: Prioritisation, Single/Combination, and Total Response. Major ethnic groups included Asian, European, indigenous Māori, and Pacific. For each classification method, statistically significant associations with ethnicity for demographic and eight sexual health indicators were assessed using multivariable logistic regression. Results Overall, 10,525 MSM provided ethnicity data. Classification methods produced different sample sizes, and there were ethnic disparities for every sexual health indicator. In multivariable analysis, when compared with European MSM, ethnic differences were inconsistent across classification systems for two of the eight sexual health outcomes: Māori MSM were less likely to report regular partner condomless anal intercourse using Prioritisation or Total Response but not Single/Combination, and Pacific MSM were more likely to report an STI diagnosis when using Total Response but not Prioritisation or Single/Combination. Conclusions Different classification approaches alter sample sizes and identification of health inequities. Future research should strive for equal explanatory power of Indigenous and ethnic minority groups and examine additional measures such as socially-assigned ethnicity and experiences of discrimination and racism. These findings have broad implications for surveillance and research that is used to inform public health responses.

Porcine epidemic diarrhea virus (PEDV) emerged into Canada in January 2014, primarily affecting sow herds. Subsequent epidemiological analyses suggested contaminated feed was the most likely transmission pathway. The primary objective of this study was to describe general biosecurity and management practices implemented in PEDV-positive sow herds and matched control herds at the time the virus emerged. The secondary objective was to determine if any of these general biosecurity and farm management practices were important in explaining PEDV infection status from January 22, 2014 to March 1, 2014. A case herd was defined as a swine herd with clinical signs and a positive test result for PEDV. A questionnaire was used to a gather 30-day history of herd management practices, animal movements on/off site, feed management practices, semen deliveries and biosecurity practices for case (n = 8) and control (n = 12) herds, primarily located in Ontario. Data was analyzed using descriptive statistics and random forests (RFs). Case herds were larger in size than control herds. Case herds had more animal movements and non-staff movements onto the site. Also, case herds had higher quantities of pigs delivered, feed deliveries and semen deliveries on-site. The biosecurity practices of case herds were considered more rigorous based on herd management, feed deliveries, transportation and truck driver practices than control herds. The RF model found that the most important variables for predicting herd status were related to herd size and feed management variables. Nonetheless, predictive accuracy of the final RF model was 72%.

Three milestone educational planning initiatives engaged the veterinary medical profession in the United States and Canada between 1987 and 2011, namely the Pew National Veterinary Education Program, the Foresight Project, and the North American Veterinary Medical Education Consortium. In a quantitative study, we investigated the impact of these initiatives on veterinary medical education through a survey of academic leaders (deans, previous deans, and associate deans for academics from veterinary medical schools that are members of the Association of American Veterinary Medical Colleges) to assess their perspectives on the initiatives and eight recommendations that were common to all three initiatives. Two of the recommendations have in effect been implemented: enable students to elect in-depth instruction and experience within a practice theme or discipline area (tracking), and increase the number of graduating veterinarians. For three of the recommendations, awareness of the issues has increased but substantial progress has not been made: promote diversity in the veterinary profession, develop a plan to reduce student debt, and develop a North American strategic plan. Lastly, three recommendations have not been accomplished: emphasize use of information more than fact recall, share educational resources to enable a cost-effective education, and standardize core admissions requirements. The educational planning initiatives did provide collaborative opportunities to discuss and determine what needs to change within veterinary medical education. Future initiatives should explore how to avoid and overcome obstacles to successful implementation.

Background/Objectives. To determine the prevalence and determinants of blood haemoglobin level and mild, moderate, and severe anemia in a sample of adults from rural Tamil Nadu, India.Subjects/Methods. We recruited a sample of men and nonpregnant women aged 20 years and older. Clinical health measures included blood haemoglobin concentration and body mass index. We assessed associations between anemia outcomes and sociodemographic and dietary factors using linear and logistic regression modeling.Results. A total of 753 individuals (412 women and 341 men) participated in this study. The prevalence of anemia was 57.2% among women and 39.3% among men (PPP>0.05). Iron intake was low; 11.7% women and 24.1% of men reported iron intakes above recommended dietary allowances (PConclusion. Both women and men in this region may be particularly vulnerable to anemia, and future research must expand beyond dietary risk factors to examine the impacts of sociodemographic and environmental factors.

Cats routinely undergo handling and restraint for examinations and procedures throughout their lifetime. In recent years there has been increased awareness that some forms of restraint have the potential to negatively impact cat health and welfare, but there has been limited research to assess alternatives. Full-body restraint is known to be aversive and cause stress responses across a range of species. The current study therefore validated measures for identifying negative cat responses to handling by comparing passive restraint (n = 22; the control treatment) to full-body restraint (n = 25; negative treatment), during a physical examination. Given that cats respond differently to unfamiliar people, and handlers are often unfamiliar to cats, an Unfamiliar Person Test was used to account for differences in cat responses to an unknown handler. Cats were then restrained according to treatment, and assessed for behavioural and physiological responses during the following phases: 1) placement into restraint, 2) restraint, and 3) post-restraint. The results show the odds of struggling were 8.2 (95% CI: 1.47, 58.53; P = .009) times greater in cats being placed into full-body restraint in comparison to passively restrained cats. During the physical examination, full-body restrained cats showed more breaths per minute (P = .004), more lip licks per minute (F1,42 = 6.18; P = .017), and were more likely to hold their ears in a back or side position during the first 15 s of handling (P

India’s constitution contains provisions for the ‘right to work’ and the ‘right to movement’ for all citizens. Established in 2005, the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) is broadly considered to operationalize this ‘right to work’. At the same time, a public discourse persists that views MGNREGA as a substitute for internal labour migration. Drawing on the results from 300 household surveys in three panchayats in the Krishnagiri district of Tamil Nadu, we test the validity of this discourse in this setting. We find that households that rely exclusively on MGNREGA have different demographic and socioeconomic characteristics compared to households that rely exclusively on remittances from internal labour migration. Furthermore, 20 per cent of households surveyed use both MGNREGA and internal labour migration as complementary livelihood strategies. We argue that there is a need for better understanding and recognition of the complementary potential of MGNREGA and internal labour migration.

Veterinary care can both positively and negatively impact animal welfare in terms of behavioural welfare. This occurs both in the veterinary clinic through interactions with patients and management of their stress, fear and aggression, and in the animal’s home through the provision of behaviour and training advice for behavioural management as a whole. An animal welfare assessment scheme, incorporating management-, resource- and animal-based measures of animal welfare through interviews and appointment observations, was developed to assess practices related to behavioural welfare in small animal veterinary clinics. It was tested for reliability, validity, and feasibility in 30 companion and mixed animal veterinary clinics, and information concerning current behavioural welfare practices was also collected. Based on weighted kappa statistics, inter-observer reliability showed almost perfect agreement for interview scoring (Kw = 0.82 and 0.81) and substantial agreement for appointment observation scoring (Kw = 0.74 and 0.70); however, at the individual question and handling item level, weighted kappa statistics for inter-observer reliability ranged greatly. Interviews were more feasible to carry out than appointment observations, although discrepancies between interview responses and veterinary staff-patient interactions observed during appointments suggest that interviews might be a less valid measure. Descriptive results suggest that there is enough variability in most assessed areas to allow for differentiation between veterinary clinics on the basis of their behavioural welfare practices. Additional research is required to explore these trends in strengths and areas for improvement in a larger sample of veterinary clinics.

The first case of porcine epidemic diarrhea (PED) in Canada was diagnosed in January 2014 in Ontario, approximately 9 months after PED emerged in the United States. An early investigation of the Canadian outbreak suspected that the probable source of the virus was contaminated feed. The objective of this study was to evaluate the role of feed and other possible factors in the early phase of the PED outbreak in Canadian swine herds. The study period of interest for this case-control study was January 22nd to March 1st, 2014. A case herd was defined as a swine herd with a confirmed positive laboratory diagnostic test (RT-PCR) results for PED virus, along with pigs exhibiting typical clinical signs at the herd level during the study period. A questionnaire was administered to participating producers from the 22 Canadian swine herds enrolled ( n = 9 case and n = 13 control herds). Case herd producers were asked to provide information from the initial day of onset of clinical signs and 30 days prior to that day. Control herds were matched to a case herd on the basis of province, herd type and approximate size. The period of interest for a control herd was matched to the initial day of clinical signs of PED for the case herd, along with the 30 days prior to this day. The questionnaire questions focused on herd demographics, biosecurity protocols, live animal movements onto and off sites, deadstock movements, feed and people movements for both the case and control herds. The questionnaire for control herds were based on their matched case’s period of interest, and together with case herds formed a matched stratum. Multivariable exact conditional logistic regression and mixed multivariable logistic regression models, with the matched stratum as a random effect, were used to assess the association between various risk factors and the odds of PED introduction into a herd. After adjusting for biosecurity practices, the odds of a PED occurrence was 38.1 (95% CI: 2.7–531.3) times greater for herds receiving feed from a single feed company that provided potentially contaminated feed ( P = 0.007) than herds that did not. The number of live pigs delivered onto sites, semen deliveries and the frequency of deadstock pickups were not associated with PED status during the initial phase of the outbreak in univariable analyses. This study supports the role of potentially contaminated feed from a single feed company as a significant risk factor for PED viral introduction during the early phase of the Canadian outbreak.

Fear and aggression in dogs within veterinary clinics can lead to canine welfare impairments and pose a safety concern for veterinary staff. However, few studies have explored potential underlying causes for this fear and aggression. We used an online cross-sectional survey targeted to current dog owners to examine risk-factors associated with fear and aggression within veterinary clinics. The factors we assessed in the survey were related to dog characteristics (e.g., sex, breed), fear and aggression responses in everyday scenarios (e.g., stranger-directed fear), experiences at the veterinary clinic (e.g., frequency of visits), training, early socialization, and owner demographics (e.g., gender, age). Data were analyzed using mixed linear regression models, with participant as a random effect to account for multiple dogs within the same household. For fear within veterinary clinics, dogs (n = 1346) were significantly more likely to be rated as fearful by their owners if they were neutered at ≤1 year of age; received their first nail trim at an older age; were rated as having severe non-social fear, or stranger-directed fear and aggression, or as being stressed or aggressive during body handling; had a negative change in behaviour after an aversive clinic experience; and if owners indicated being nervous during situations within the veterinary clinic. For aggression within veterinary clinics, dogs (n = 1776) were more likely to be rated as aggressive if they were reported to be fearful of the veterinary clinic, fearful of feet toweling, or stressed or aggressive during body handling, if the owner reported using positive punishment during routine training, or if any of the following had occurred during clinic visits: examination shortened, use of towel restraint or muzzling, dog bite directed at staff member, general use of positive punishment on the dog, and if the owner indicated being nervous during situations within the veterinary clinic. Random effects for participant were significant for both fear and aggression models, with intra-class correlation coefficients of 0.36 (CI: 0.21−0.54, p = 0.0004) and 0.16 (CI: 0.06−0.36, p = 0.017), respectively, indicating some correlation in behaviour amongst dogs owned by the same person. These results suggest that both fear and aggression within veterinary clinics are related to dog personality, previous early experiences and veterinary clinic experiences, and owner experiences during veterinary visits. These findings can be used to generate hypotheses for future research aimed at preventing the development of fear and aggression within a veterinary setting.

This case study examines the impact of the Bwaliro Primary School feeding and agroforestry program on the human, financial, natural, and social capitals of the surrounding Bwaliro community in western Kenya. Additional to the targeted improvements in attendance and educational performance, program spillover effects likely included enhanced child health, community agroforestry knowledge, increased tree planting and diversity of crops and trees, saved household income, and improved relations within the family unit and among community members. Participants suggested that increasing the community's capacity to contribute to and collaborate with the school is necessary for program sustenance and for further community development.

Many dogs show signs of fear during veterinary appointments. It is widely recommended to use desensitization and counter-conditioning training to reduce this fear. However, the efficacy of this method for reducing veterinary fear has not been examined. We assessed the effect of a standardized four-week training program on behavioural and physiological signs of fear in dogs with pre-existing veterinary fear. Owned dogs were randomly allocated to receive training (n = 15) or no training (n = 22, Control). Owners of dogs in the training group were instructed to perform exam-style handling on their dog and to visit the veterinary clinic weekly. Owners of control dogs were given no instructions. Fear responses were assessed before and after the training period by a blinded observer during clinic arrival and examination. Despite motivated owners volunteering to participate in the current study, 44% of owners were non-compliant to this training program. During examination, control dogs had higher odds (95% confidence Interval (CI)) of reduced posture compared to trained dogs (Odds ratio (OR): 3.79, CI: 1.03&ndash, 16.3). Fear scores for trained dogs lowered during the second examination (p = 0.046), and 86.7% of dog owners reported a reduction in their dog&rsquo, s fear levels across the training period (p = 0.007). When entering the clinic (p = 0.002) and during examination (p = 0.002), trained female dogs had a higher rate of lip licking than control females. The training program did not influence temperature, heart rate, respiratory rate, avoidance, trembling, vocalizations, or willingness and encouragement to step on the scale. Results suggest that this four-week training program was mildly effective at reducing veterinary fear in dogs. Further research is necessary to explore the efficacy of longer, more intensive, and individualized training programs.

Background Beliefs of pet owners strongly influence their decision-making surrounding their pets’ diet. Thus, nutritional guidance is an essential component of veterinary practice and integral to managing rising rates of pet obesity. This study examined pet owners’ trust of, perceived effectiveness of, and intentions to follow nutritional guidance received from their veterinarian in managing their pets’ diet. Methods A cross-sectional study of 1402 dog and cat owners in the USA and Canada was conducted using an online questionnaire tool. Data were analysed using descriptive statistics and logistic regression modelling. Results Clients are concerned about the effectiveness of veterinary nutrition recommendations. Cat owners were more likely than dog owners to consider the nutritional guidance they receive from veterinarians effective for their pets’ diet (1.75, P=0.04). Length of pet ownership, feeding dry diets and frequency of veterinary visits were all positively associated with owners considering veterinary nutritional guidance to be effective in managing pets’ diet. Conclusion Identifying these perspectives can aid in developing strategies to provide nutrition support to pet owners to improve their perceptions of, self-efficacy with, and compliance with veterinary nutrition recommendations.