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Medium 9781780644554

16: A Military Case Study

Wapling, A. CABI PDF


A Military Case Study

D. Ross and A. Charnick

Army Health Unit, Former Army Staff College, Surrey, UK

Key Questions 

• What are the lessons that can be learned from military deployments to ensure a timely

­response and resilience?

• How does the military prepare, maintain and recover its forces in response to an emergency?

• What is the ‘continuum of care’?

Box 16.1.  Setting the scene 

An East African country is heading towards instability as a result of organized groups of militias, which have formed together in an armed opposition to the elected government of the country.

The militias have been moving across the country and a significant number of internally displaced persons (IDPs) are being driven into the government-controlled areas. This has affected the government’s ability to combat the militias, as it has to split resources away from combat operations to support the IDPs. The government has requested assistance from both the African Union and the United Nations (UN) in dealing with the insurgency and the IDPs and their security and life support. Following a Security Council meeting it has been agreed that a UN-mandated peacekeeping force will be deployed to assist in the stabilization of the country and to provide support to the IDPs. The UK is providing an infantry battalion and logistic troops to the UN-led force. In addition to this, West Africa is in the middle of an outbreak of viral haemorrhagic fever.

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Medium 9781786394040

4 Parasites of the Cardiovascular System

Elsheikha, H.M.; Wright, I.; McGarry, J. CABI PDF


Parasites of the

Cardiovascular System


What is babesiosis?

Babesiosis is a blood protozoal disease caused by tick-transmitted intra-erythrocytic protozoa of the genus Babesia. These protozoan organisms live inside the red blood cells of animals.

How many Babesia species infect dogs?

A number of Babesia spp., including Babesia canis, B. gibsoni, B. vogelii and

B. vulpes, are known to infect dogs in Europe. The two Babesia species most commonly infecting dogs are the large piroplasm (B. canis) and the small piroplasm (B. gibsoni). The former usually occur in pairs and appear pearshaped, while the latter are smaller and circular.

What is known about the epidemiology of Babesia infection in the UK?

Even though babesiosis has been reported in an untravelled British dog, babesiosis has been considered an exotic disease and only identified in dogs returning from travel to Europe. However, in 2016 babesiosis due to B. canis was confirmed in four dogs from Essex with no history of foreign travel and

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Medium 9781786391728

3. Key Features of the Council for Science and Society (CSS) Report 1988

Hall, S.; Dolling, L.; Bristow, K. CABI PDF

Key Features of the Council for

Science and Society (CSS) Report



To put the current work in context, it is useful to review the scope and findings of the 1988 Council for Science and Society (CSS) report on animals in society, before considering the ways in which the figures may be updated, associated challenges and how the position of companion animals in society has developed (see later chapters). This was the first comprehensive evaluation of its kind to specifically consider companion animals in the UK. This report reflected on the extent and economic significance of the companion animal in society, as well as the benefits and problems that they bring.

The three main domains identified in the report were:

1. The extent and economic significance of the pet-keeping phenomenon.

2. The benefits of pet ownership.

3. The associated problems of pet ownership.

As we have noted already, the CSS report highlights the difficulty in distinguishing between the ‘pet’ and ‘working’ animal within some human– animal relationships. We retain the use of the term ‘pet’ in this chapter, in line with the original report.

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Medium 9781786391520

14 Vaccination of Domestic and Wild Animals Against Tuberculosis

Chambers, M.; Gordon, S.; Olea-Popelka, F. CABI PDF


Vaccination of Domestic and Wild

Animals Against Tuberculosis

Bryce M. Buddle,1,* Natalie A. Parlane,1 Mark A. Chambers2,3 and

Christian Gortázar4


Hopkirk Research Institute, Palmerston North, New Zealand; and Plant Health Agency – Weybridge, Addlestone, Surrey, UK; 3School of

Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, UK;

4SaBio – Instituto de Investigación en Recursos Cinegéticos IREC, Universidad de

Castilla-La Mancha & CSIC, Ciudad Real, Spain


14.1 Introduction

Mycobacterium bovis has a very wide host range and is the predominant cause of tuberculosis

(TB) affecting domestic and wild animals, although tuberculosis in animals can also be caused by other members of the Mycobacterium tuberculosis complex. The disease in cattle, defined as bovine TB, continues to be a major economic animal health problem worldwide

(Waters et al., 2012). The test-and-slaughter bovine TB control programmes introduced in many countries in the mid-20th century achieved dramatic results and a number of countries were able to eradicate this disease.

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Medium 9781780644394

34 Role of Antimicrobial Stewardship in a Community Hospital

LaPlante. K.; Cunha, C.; Morrill, H. CABI PDF


Role of Antimicrobial Stewardship in a Community Hospital

Sandy J. Estrada* and Aileen Martinez

Lee Memorial Health System, Fort Myers, Florida, US; Martin Health ­System,

Stuart, Florida, US


Antimicrobial stewardship programs (ASPs) are often associated with larger academic medical centers, although the majority of hospitals in the US are actually community hospitals. According to 2012 data from the National Healthcare Safety Network

(NHSN) of the Centers for Disease Control and

Prevention (CDC), out of 3742 acute care hospitals submitting data, 70% defined themselves as nonteaching institutions (Dudeck et al., 2013). Thus, in order to make a significant impact on antimicrobial usage and resistance in community hospitals, the implementation of ASP strategies is vital.

Antimicrobial stewardship guidelines were first published in 2007, viz., the guidelines for developing an institutional program to enhance microbial stewardship from the Infectious Diseases Society of America (IDSA) and the Society for Healthcare

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Medium 9781626569072

15. Reframing The Practice Of Managing As caring before curing

Mintzberg, Henry Berrett-Koehler Publishers ePub

As caring before curing

Healthy institutions require a management style dedicated to care, so as to reduce the need for cure. That’s why nursing may be a better model for managing than medicine (Mintzberg 1994; 2009a: 245–248).

I am obviously not referring to the boss style of managing exemplified by Nurse Ratched in One Flew over the Cuckoo’s Nest. Nor am I referring to the belief in some quarters that management is somehow a profession. It is a practice, rooted in context, and therefore learned initially from basic experience on the job. (Later we shall discuss a forum for developing people who manage.)

There is an increasingly fashionable approach to managing these days, which you can tell by what it is not called: management. It is called “leadership,” apart from management—supposedly grander, more noble. Yet watch an effective manger in health care—the head nurse of a clinic, the executive director of a hospital, whoever—and try to separate that person’s leading from his or her managing.1

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Medium 9781786391520

11 Adaptive Immunity

Chambers, M.; Gordon, S.; Olea-Popelka, F. CABI PDF


Adaptive Immunity

Jayne Hope1,* and Dirk Werling2


Roslin Institute, University of Edinburgh, Edinburgh, UK;

2The Royal Veterinary College, Hatfield, UK

Immunity to mycobacterial infections is an interplay between innate and adaptive immune responses; both cellular and humoral mechanisms are involved. While it is clear that the response to mycobacterial infection is driven and shaped by the initial innate immune response, defining the mechanisms of adaptive immunity underpins on-going efforts to develop effective tuberculosis (TB) vaccines for humans and

­cattle. Importantly, definition of correlates of protective immunity that can be measured readily will facilitate the development and screening of vaccine candidates and assessment of their success. However, it must also be stressed that in the case of mycobacterial infection, these correlates of protective immunity must be defined carefully. They not only include an ‘absence of clinical symptoms’, a definition used for many other veterinary vaccines, but must be defined as ‘protection to infection’, given the socio-­ economic importance of infection with Mycobacterium bovis. In addition, since measurement of the adaptive immune response through tuberculin skin testing or assessment of antigenspecific IFN-g release forms the basis of currently used diagnostic tests (Waters et al 2011; Pai et al., 2014), increased knowledge of the immune response associated with infection or induced by vaccination is required for improved surveillance.

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Medium 9780433308829

CHAPTER ELEVEN. Notes on the psychotherapy of infantile autism

Michael Fordham Karnac Books ePub

There are a number of defined ways of treating autism. The children may be removed from home either as an emergency operation or as part of a treatment strategy (cf. Goldfarb, 1961, Bettelheim, 1967). In an institution the environment may be used by adults in varying ways. The one relevant to this discussion aims to let the children regress with the idea that they will, in the course of time, reach the source of their traumata and relive in a more healthy and normal way the earlier situations that caused the disorder.

Bettelheim (1967) has conducted the most thorough long-term project of treating autistic children away from home. By providing consistent and skilful management over years he obtained improvements that appear to be greater than would be expected without the treatment. His study is the most encouraging so far conducted.

The need for special care, so well documented by him, has been supplemented by Winnicott’s demonstration that a psychotic child’s mother could provide it; he also uncovered splitting processes in a therapeutic consultation with favourable results, which the family could build upon.

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Medium 9781609945176

Seven Who Cares about Quality?

Longman, Phillip Berrett-Koehler Publishers ePub

Medical economist J.D. Kleinke makes a revealing comparison between casinos and hospitals. Suppose you go to Las Vegas and after winning a few bets get hooked. When you start losing, you find yourself going to the cage and converting all the money in your wallet into chips. Next you max out your credit cards. Later that night, with Lady Luck still flirting but denying you the big score, you convert your checking and savings accounts into still more chips. When these are gone twenty-four hours later, the casino happily lends you another $25,000 worth of chips, which represents 40 percent of your retirement account and 30 percent of the equity in your home. Then, sipping on yet another free scotch, you make one big last bet at the craps table and are suddenly struck by a massive heart attack.

An ambulance rushes you to the nearest hospital. What’s different about your new location? For one, you’ve gone from an institution that knows lots about you and your past to one that knows practically, or maybe even literally, nothing. The casino, before it processed your credit cards or lent you money, used advanced but routine information technology to discover details about your life, such as your current employer, whether you’ve been caught at or suspected of cheating in another casino, your bank account balances, whether there are liens on your house, and whether your life insurance is paid up. All it needed to retrieve these details was your name, Social Security number, and a modest investment in information technology.

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Medium 9781780647463

8: Anesthesia

Scott, D.E. CABI PDF



Learning Objectives

1. Basic anesthetic protocols.

2. Proper oxygen flow rates and endotracheal tube


3. Safe monitoring of vital signs.

Induction and maintenance of anesthesia in raptors is relatively easy but, as with all species, careful monitoring is always necessary. Gas anesthesia is usually the safest and most convenient method. A nonrebreathing system such as an Ayers T-piece configuration with a high flow rate (Fig. 8.1) should be used.

Isoflurane works very well, is safe, and has a fast duration of onset and recovery. Newer gases such as sevoflurane are also becoming popular and may be advantageous in patients with cardiac arrhythmias.

Induction is carried out by masking the bird down with 3–4% isoflurane in oxygen at a flow rate of at least 1 liter/min/kg.

Pre-oxygenation and premedication/pre-­emptive analgesia with butorphanol are very useful and are highly recommended. Birds appear to have a predominance of kappa opioid receptors so

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Medium 9781780642994

21 Measurement of Dietary Diversity for Monitoring the Impact of Food-based Approaches

Thompson, B., Amoroso, L. CABI PDF


Measurement of Dietary Diversity for Monitoring the Impact of Food-based


Nutrition and Consumer Protection Division (AGN),*† Agriculture and Consumer Protection Department (AG)

Food and Agriculture Organization of the United Nations, Rome, Italy


Monotonous diets based mainly on energy-dense, but micronutrient-poor starchy staples are common in food-insecure areas and contribute to the burden of malnutrition, particularly to inadequate micronutrient intake. Food-based strategies have been recommended as the first priority to meet micronutrient needs.

An essential element to food-based approaches involves dietary diversification – or the consumption of a wide variety of foods across nutritionally distinct food groups. Increased dietary diversity is associated with increased household access to food as well as increased individual probability of adequate micronutrient intake. Dietary diversity is measured as the number of individual food groups consumed over a given reference period. FAO has developed guidelines on the use of a standardized tool for measuring dietary diversity that can be administered at either the household or individual level. The tool uses an open recall method to gather information on all the foods and drinks consumed by the household or individual over the previous 24 h. The foods and drinks mentioned by the respondent are then recorded into one of 16 standardized food groups. Data collected using the dietary diversity tool can then be analysed in several different ways to provide a picture of dietary patterns within a community as well as among vulnerable groups. Examples of analytical approaches and programmatic uses are drawn from studies in

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Medium 9781786394583

‘Long-stay Dogs’ in Shelters: Studying Factors Related to Adoptability of Difficult to Adopt Dogs in Catalonia

Denenberg, S. CABI PDF

�‘Long-stay Dogs’ in Shelters:

Studying Factors Related to

Adoptability of Difficult to Adopt

Dogs in Catalonia

Marta Calcerrada1*, Lorena Torre1, Paula Calvo1,

Jonathan Bowen1,2 and Jaume Fatjó1

Chair Affinity Foundation Animals and Health, Universitat Autònoma de

Barcelona,Spain; 2Royal Veterinary College, University of London, UK


Conflict of interest: The authors declare no conflict of interest.

Keywords: long-stay, dogs, adoption, shelter, behaviour problems


Animal shelters usually house ‘long-stay dogs’, whose characteristics make their adoption difficult. Their main profiles include: dangerous (under Spanish legislation), senior, chronic disease or with behavioural problems. Our aim was to explore the motivations of potential adopters when choosing these dogs.

Material and Methods

An online survey investigated general motivations for dog adoption and responsible ownership. Participants were recruited via email campaigns from three shelters in Catalonia. Kruskal–Wallis (KW), and Mann–Whitney U tests were performed to compare scoring for dog profiles and analyse factors related to motivations to adopting each.

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Medium 9780253012241

Introduction. Disciplinary Limits: Philosophy, Bioethics, and the Medical Management of Atypical Sex

Ellen K. Feder Indiana University Press ePub

The Birth of a child with ambiguous genitalia constitutes a social emergency.” So begins the statement published in 2000 by the American Academy of Pediatrics (AAP) titled “Evaluation of Newborn with Developmental Anomalies of the External Genitalia.” What the AAP means by “social emergency” appears to concern the emotional confusion and distress that parents may immediately experience upon learning they have a newborn with atypical sex, meaning a sex anatomy that is neither clearly male nor clearly female. “Words spoken in the delivery room,” the statement continues, “may have a lasting impact on parents and the relationship with their infant.” It is especially important that medical personnel take care in discussions of “the infant [who] should be referred to as ‘your baby,’ or ‘your child’—not ‘it,’ ‘he,’ or ‘she’” (2000, 138). As damaging as a mistaken assignment of gender would be for the parents and the child is the kind of treatment that denies the infant’s personhood. We may readily appreciate the difficulty parents and medical professionals face when they are so challenged by an infant’s anatomy that they risk causing harm to the child and to the relationship between the child and those charged with caring for the child.

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Medium 9781845936839

15: Spatial Epidemiology

Sergeant, E.; Perkins, N. CABI PDF


Spatial Epidemiology

15.1  Introduction

Proximity can influence the occurrence of both infectious and non-infectious diseases

(Pfeiffer et al., 2008). For example, spatial or temporal proximity may increase the probability of contact between infectious and naive individuals resulting in an increased probability of infectious disease transmission. Likewise spatial proximity to an environmental risk factor may increase the local occurrence of a non-communicable disease. Hence consideration of spatial and temporal information during assessment of disease (or infection) is often important to avoid errors (confounded inferences) about risk factors for disease. Fortunately, the development of powerful computers, suitable software and readily accessible spatial data has led to the rapid uptake and development of spatial methods in epidemiology.

Spatial epidemiology is the description and analysis of geographic variations in disease with respect to demographic, environmental, behavioural, socio-economic, genetic and infectious risk factors (Elliott and Wartenberg, 2004). This definition could be expanded to include temporal factors because temporal considerations are often a critical and interlinked part of spatial epidemiology, especially in infectious disease transmission

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Medium 9781780646824

6: Missionaries of Death

Webber, R. CABI PDF

Missionaries of Death



John Williams, the great missionary from the London Missionary Society

(LMS), had achieved remarkable success in converting most of the Polynesian people to Christianity. Within just a few years, he had seen the transformation of these distant Pacific Islanders from war-mongering cannibals to passive Christians. Now he was to turn his attention to the much bigger challenge of the Melanesian (meaning ‘black’) Islands. He felt sure he was going to succeed: against all odds he had done so in Samoa (Fig. 6.1), he had

God on his side, soon he would be able to claim even greater numbers of converts to the religion he so believed in.

He had chosen to launch his crusade on the island of Tanna, part of what was then called the New Hebrides, so named by Captain Cook, who was probably thinking of places nearer home. Williams left a couple of his missionaries to learn the language and then proceeded to Erromanga

(now Erromango) to do the same. However, when he went ashore he was immediately clubbed to death, so it is not on the coral islands of Polynesia that the great missionary is buried, but on Erromanga that his grave is to be found. It is likely that he was thought to be a sandalwooder, one of the unscrupulous exploiters of the precious sandalwood, so landing unarmed made him easy prey.

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