key: cord-0009767-ldkjqco6 authors: nan title: NEWS date: 2014-10-28 journal: Aust Vet J DOI: 10.1111/avj.137 sha: fc86024fc7bea767427ae6c078365b967dd8cd66 doc_id: 9767 cord_uid: ldkjqco6 nan R eports of psychological distress, occupational stress and burnout and an increased risk of suicide in the veterinary profession are urgent reminders that veterinary schools, professional organisations and also employers should continue to address these issues. 1, 2 Managerial aspects of the job, long working hours, heavy workload, poor work-life balance, difficult client relations and performing euthanasias have been consistently associated with increased levels of occupational stress. 1 Chronic work stress can lead to emotional exhaustion and burnout. 3 Female veterinarians, younger veterinarians and those working on their own are at greatest risk of stress and mental health difficulties. 1, 4 Results from a recent observational study conducted at veterinary practices in Canada suggest that team effectiveness can improve an individual team member's job satisfaction and offer protection against stress and burnout. 3 The study found that 35% of veterinary team members were considered to be at a high risk of burnout. The study recommendations are that practice managers: • ensure all team members are kept abreast of changes in the clinic and given opportunities to provide suggestions to improve patient care and client service • recognise team members for their contributions • provide all staff with adequate resources and guidance to complete their jobs in a meaningful fashion and provide opportunities for growth and professional development • ensure all team members have clearly defined roles and are given autonomy to make decisions consistent with their position in the practice • encourage colleagues and supervisors to provide guidance and social support to help team members develop coping skills • take steps to create and maintain a positive work environment -this may include addressing conflicts among co-workers, ensuring all employees are treated equally and fairly, promoting civility and collegiality • consider current staff numbers and individual workloads to prevent excessive workload. Providing communication and coping skills training and improving cognitive skills for young professionals may also help to decrease depression, anxiety, stress and burnout. 3 If you are concerned that a colleague, close friend or family member is experiencing mental health difficulties, try talking to them in a supportive manner and encourage them to consult their GP or mental health professional. A 24-hour telephone counselling service is available for AVA members on 1800 337 068. This service can also arrange a counsellor to attend veterinary workplaces to help support staff after a traumatic incident. Lifeline is another excellent support option: 13 11 14 . Dogs suffering from osteoarthritis need proven relief from pain and infl ammation. Julia Nicholls, President A s I write, our Policy Advisory Council (PAC) is voting on policies that are under review or newly drafted. So it may be a good time to reflect on why we have these polices and how they are written, as there has also been some debate about the function and process of the PAC. AVA policies are used as a reference point for the public, the media and members. Many of our members sit on external boards and committees and the policies are key documents in these forums. I recently had to respond to a good question as to why our policy on equine dentistry did not completely align with the recommended key principles for veterinary practice Acts in Australia, which were recently circulated to members (www.ava.com.au/node/13542). The crux of this is that the policy reflects an ideal world, but the veterinary practice Acts, which are written for the protection of the public, reflect current reality. We have other policies that do not align with those of key stakeholders or with current legislation. This is healthy and reflects our independence and the democratic process. The AVA has approximately 140 policies and position statements. Subjects range from live animal export to genetic defects in domestic animals, and from puppy socialisation to cane toad euthanasia. Position statements replace policies where there is a significant diversity of opinion among members. Many policies reflect our stance on animal welfare issues and this is something to be proud of. The PAC consists of a representative from every division and special interest group and meets once a year face-to-face but engages in healthy debate online all year. The full process of policy development may seem long-winded to an outsider. An initial draft is created by a working group and is then discussed by all the councillors until the majority are happy that the policy is suitable to go to all members for comment. Members have a chance to comment on draft policies twice each year. The councillors work very hard to gain consensus from the members and to work with each other to get a policy ready for the vote. The October voting round is an electronic vote for policies that have been discussed online or have been out for general member comment. Councillors vote whether to move each policy to the next stage in the process, send it back to a working group or abandon it altogether. Anything requiring more debate is referred to the face-to-face meeting in May. The final sign off is by the AVA Board. The structure of the AVA's policies is important. They should start with a short statement suitable for a media release or sound bite and then have a section on the underlying philosophy, the evidence and some scientific references. Operational matters or procedures linked to the policy are usually included as guidelines. Each policy undergoes regular review to maintain currency. Some are deleted and others added as the environment changes. The Policy Compendium is a living document and something that is the envy of other veterinary associations. It is hard to see any shortcuts that would improve the process for member involvement. Yet situations occur where we have no policy to fall back on. In the world of the 24-hour news cycle, topics arise that require an immediate response or at least one faster than the formal policy development process. The changes to higher education funding are a case in point. We do not have a policy on this, but it was clear that the proposed changes pose a threat to the future viability of our profession. We believe that we have to oppose this government policy shift, so we are, hopefully with your support. Another example is where we have a policy but it is silent on the particular aspect of the topic under debate. In these circumstances, the Board or a consultative group delegated by the Board will arrive at an official position in keeping with the spirit of our policies. Ideally, a policy will eventually flow from experiences like these. Members and Board directors have asked a range of questions about our policy development process in recent years: • Should there be more scanning and identification of futureproofing policies? Pet insurance is an increasingly important element of economic sustainability for many members. It means that clinical veterinarians can provide the best care for their patients and clients, regardless of the cost. Unfortunately, there have been a number of teething problems with policies and claims, which led us to form a Pet Insurance Taskforce in 2013. The Taskforce's role is to work with the profession and pet insurance companies to identify and then address issues of concern for veterinarians, pet owners and the insurance companies. Our ultimate goal is to ensure that pet owners and veterinarians have confidence in pet insurance as a trustworthy and valuable element of pet care. One of the key activities the taskforce has undertaken is to develop a Veterinarians guide to pet health insurance. The guide includes: • general information on what pet insurance is (and isn't) • useful facts about the Australian market • reasons why more clients don't use pet insurance • techniques for making pet insurance work in your practice and for your clients. It also includes our guidelines for promoting pet insurance, your legal obligations, and what you can and can't say when talking to clients. We've heard from many members who are confused about this area, and the guidelines provide some much needed clarity. A Veterinarians guide to pet health insurance is available for download now from the AVA website: www.ava.com.au/node/14596. On the back of member a survey conducted earlier this year, the Taskforce is now gathering more detailed feedback including case studies from members at conferences and other forums. The feedback highlights several areas we believe could be addressed to remove barriers to take-up of pet insurance in Australia, including: • the need for a cooling off period so that the pet owner can withdraw from an insurance policy if they are dissatisfied with the exclusions • the need for clearer terms and conditions, and explanations of any exclusions at the time of policy uptake • removing policy exclusions for pre-existing conditions based on entire body systems and unrelated to previous conditions -for example, removal of a toe lump cannot be considered a pre-existing condition just because a dog had a superficial skin infection a year before • making it easier for clients to know if their policy provides cover for particular treatments and diagnostic tests • an improved review of disputed claims by Australianregistered veterinarians -we think that an industry review panel of AVA members would offer an alternative pathway for appeal to the Financial Industry Ombudsman • moving to electronic submission of claims, and making interactions with the insurers more efficient for veterinarians. We're looking forward to engaging with the insurance companies over these and other issues in the coming weeks. We'll keep you up-to-date with any new developments, and we also plan to develop some more educational resources for veterinarians shortly. With changes to the way the insurance policies and claims process works, we anticipate that more and more pet owners will choose to insure their pets, resulting in more treatment options. It will also mean that veterinarians are working with a system that supports good outcomes for all involved -pets, owners and veterinarians. Fun is like life insurance; the older you get, the more it costs. International veterinary, biomedical and business journals at your fingertips Vet Ed library: www.ava.com.au/library As a vet, you are used to handling your patients with care and understanding, (especially if their bite is worse than their bark). At BOQ Specialist, we adopt the same approach. We've spent nearly 20 years working closely with vets and we've come to know your world as well as we do our own. We know your idiosyncrasies and we can anticipate your needs. So, unlike a conventional bank, we've developed products and services that are carefully designed to meet your business and personal banking requirements. When you call us, you'll always feel you are dealing with one of your own breed. Crayfish plague is caused by a water mould, Aphanomyces astaci. Its native hosts are North American freshwater crayfish and although it produces some minor pathology, does not usually cause death. However, in naïve crayfish (never exposed to the pathogen), the disease causes death and effectively exterminates native crayfish from infected waters in as little as a couple of weeks. Historically, North American crayfish were first introduced into Europe in the late 1800s for culture and fishery purposes. They carried crayfish plague with them. Crayfish plague travelled around Europe, with American crayfish that were translocated into European waterways. However, once crayfish plague was introduced to a country, it would also spread rapidly via contaminated fishing gear and water. Crayfish plague continues to spread to previously unaffected areas of Europe. The effect was severe in areas with a culture of consuming crayfish, particularly Scandinavia. National declines in crayfish populations vary from 50% to 80% and lakes where crayfish were eliminated became overgrown with aquatic plants. 1 In Finland, the estimated cumulative direct loss from crayfish plague over the past 90 years is €630 million. 2 Australia's freshwater crayfish fauna is diverse, with over 135 described species, including a large number that are rare and endangered. Crayfish play a crucial role as predators, herbivores and in breaking down detritus in freshwater ecosystems, and are often the largest animals in Australian mountain streams. Australian crayfish can be split into two broad groups: spiny and smooth-shelled crayfish. Spiny crayfish are slow growing, have very large claws and usually prefer clear, cool water. Because of their low meat yield and slow growth, they are not farmed. They are important fauna of streams where habitat is suitable, and many have highly restricted distributions, low fecundity and are listed as endangered. The best known of the spiny crayfish is the Murray River cray (Euastacus armatus). Smooth-shelled crayfish include commercially and recreationally important species such as marron (Cherax cainii), redclaw crayfish (Cherax quadricarinatus), and the ubiquitous 'yabby' (Cherax spp.). Marron, redclaw and yabbies are farmed in Queensland, New South Wales, South Australia and Western Australia. Marron are primarily farmed in Western Australia and South Australia. Annual production varies, but in 2011-12 it was valued at A$1.44 million and A$343,000, respectively. 3 Redclaw production in Queensland has declined over the past 10 years and is now valued at A$792,000. Yabby production for food is limited, mainly from farms in Western Australia ($377,000) and New South Wales ($325,000). Redclaw and yabbies have been translocated (legally and illegally) for recreational fishing. Many species have substantial cultural importance, and have been a source of food for indigenous people for millennia. Crayfish are 'keystone species' in aquatic environments, acting as major processors of organic materials, facilitating the release of energy and nutrients, turning over substrates and aerating soil, and can reach very high biomasses in some systems. Some smooth-shelled crayfish are remarkably persistent in dry environments and can survive drought in deep burrows for extended periods. Aphanomyces astaci spreads by means of motile zoospores released from mature filaments in infected crayfish. The zoospores are attracted to crayfish cuticle, and the filaments penetrate immediately. Zoospores can remain motile for up to 3 days and cysts can survive for 2 weeks (in distilled water). 4 Zoospores can re-encyst three times if they do not encounter a host. It is recommended to wait 3 months before attempting to re-stock waters in which crayfish have been killed by crayfish plague, to allow all zoospores to die out. Crayfish plague is also spread via contaminated fishing equipment or zoospores in water. 5 American crayfish, including red swamp crawfish (Procambarus clarkii) and signal crayfish (Pacifastacus leniusculus) are tolerant of infection. They can remain carriers for life, and may exhibit little or no sign of infection. Until recently, crayfish plague was only known in temperate to cool climates, but a Spanish strain is active at temperatures of 18-25°C. The strain that affects the invasive red swamp crawfish can sporulate at temperatures up to 29.5°C. 4 Red swamp crawfish have established in Japan, China and Taiwan, and populations are sometimes maintained in ornamental fish outlets in the region. 1 Thus there is potential for spread of the pathogen throughout the region, either in contaminated water or with live or dead crayfish. Freshwater crabs are susceptible to crayfish plague and may act as reservoirs for the pathogen. The Chinese mitten crab (Eriocheir sinensis) and the European crab (Potamon potamios) are both susceptible to infection with crayfish plague. 6 The Chinese mitten crab is listed as one of the most invasive species on the planet and has established successfully in Europe and North America. Australia has very rich and diverse freshwater crab fauna. If infected Chinese mitten crabs established in Australia, their extensive migration habits (migrating upstream from estuary spawning grounds) could spread crayfish plague inland to crayfish and crab populations. Australian crayfish are known to be highly susceptible to crayfish plague. 7 Eight species of four genera (including yabbies, Cherax destructor) of Australian crayfish were experimentally exposed to zoospores of A. astaci. They showed limited or little effective host response to invading filaments. The usual response of crayfish to infection is encapsulation and melanisation of invading filaments. Redclaw crayfish and marron have been introduced into many countries for farming purposes. In late 2013, crayfish plague was detected in farmed redclaw crayfish in Taiwan. 8 It was detected in five widely spread locations, four of which experienced 100% mortality, while one experienced 5% mortality and 20% morbidity. Pathology was not described in the report. As demonstrated by its ability to infect multiple crayfish species, Chinese mitten crabs and European crabs, crayfish plague is not very species-specific and could potentially infect most or all Australian freshwater crayfish and crab species. It can cause disease and death in crabs, although the effects are not as immediate or dramatic as in crayfish. Often the first sign of crayfish plague is the sudden mass death of crayfish in a water body. However, some symptoms do appear, including behavioural changes and external signs. Affected crayfish may become active in the day and appear uncoordinated and lethargic. Whitish areas in the muscle may be visible through the cuticle under the tail. At very low temperatures (<5°C) effects may be slower to emerge, and the disease may be chronic rather than lethal in susceptible species. When American crayfish species (i.e. tolerant of infection but carry it) become infected, the shell may develop dark patches, as the reaction by crayfish to damage is to lay down melanin around the pathogen. These patches are easiest to see on the underside along the abdomen. The Identification field guide to aquatic animal diseases of significance to Australia provides details of clinical signs and diagnosis for crayfish plague. 9 The AQUAVETPLAN disease strategy manual for crayfish plague provides details on gross and clinical signs of the disease. 10 Crayfish plague should be differentiated from other possible causes of mass death, such as insecticide poisoning. PCR techniques for detection of the pathogen have been developed. There is an Australian and New Zealand Standard Diagnostic Procedure detailing methods for diagnosing crayfish plague. 11 The OIE manual of diagnostic tests for aquatic animals also provides details on diagnostics to confirm the presence of the pathogen. 12 Australian freshwater crayfish are known to be susceptible to crayfish plague fungus. Freshwater crayfish are important and dominate in many Australian ecosystems, and many species are rare or threatened. 13 Many species have restricted distributions, so could become extinct very rapidly if exposed to the disease. Crayfish are the basis of an aquaculture industry, as well as supporting recreational and cultural fisheries. The potential consequences of entry of this disease into Australia could be severe. The 2013 outbreak in Taiwan is the first reported case of Australian native crayfish being naturally infected by A. astaci and demonstrates the high susceptibility of this tropical crayfish to the pathogen. It caused very high mortalities, suggesting that a similar outbreak in Australia could have devastating consequences. Some strains of crayfish plague fungus are temperate but others transmit in temperatures up to 29.5°C, suggesting that crayfish plague could infect large areas of Australia. American crayfish are widespread in Asia. They are regarded as pests in some countries, and until recently crayfish plague had not been reported from Asia. The report from Taiwan indicates that plague is present and could, potentially, be widespread in the region in feral populations of North American crayfish or Chinese mitten crabs. Australia has import conditions to restrict the entry of freshwater crayfish or crabs for both environmental and biosecurity reasons. These conditions limit the risk of entry of crayfish plague into Australia. However, vigilance for diseases should always be maintained. If an exotic disease is suspected, please call the disease watch hotline 1800 675 888 for advice and assistance. Brett Herbert Australian Government Department of Agriculture Comment on this article at www.ava.com.au/13302 R abies is present in more than 100 countries across the world, causing more than 50,000 human deaths each year, almost all of them in Africa and Asia and many of them young children. Although rabies can infect all warm-blooded animals, the most important source of human infection around the world is an infected dog bite or scratch. Australia is one of the few countries that claims freedom from the disease, but as the rabies virus spreads in nearby countries, it is becoming more likely that it will eventually reach our shores. Honorary Associate Professor at the University of Sydney, Dr Helen Scott-Orr, has been involved in rabies programs in Flores, as well as early response and control programs when rabies was first diagnosed in Bali in 2008. "Rabies is a terrible and terrifying disease when it occurs. It exists in canine populations on several Indonesian islands close to our northern shores. In recent years there have been outbreaks on eastern islands, including Bali, Flores, Ambon and the Tanimbar Islands, which have increased the risk of the disease entering Australia. "If it were to reach our border, the most likely place for an incursion is northern Australia and the most likely scenario is an illegally imported, infected animal arriving by boat, " Dr Scott-Orr said. Dr Ted Donelan is President of Animal Management in Rural and Remote Indigenous Communities (AMRRIC), which delivers animal health programs in rural and remote Aboriginal and Torres Strait Islander communities. Dr Donelan says that people in isolated Indigenous communities are most at threat from a rabies outbreak. "Large portions of the northern Australian coastline are very sparsely populated. There are significant populations of semi-free-ranging camp dogs, dingos and other wild dogs in and around these communities. If these dogs became infected, they would pose a huge threat to the health and safety of the Aboriginal and Torres Strait Islander people living in those areas, " Dr Donelan said. The Australian Government has been active in rabies preparedness and prevention. The Minister for Agriculture, Barnaby Joyce, recently said, "The work offshore, at our borders and on shore -including the department's engagement with Indigenous communities in Northern Australia as part of the Northern Australia Quarantine Strategy (NAQS) -is vitally important to ensuring Australia maintains its freedom from rabies and other exotic diseases. " Since 2011, the Department of Agriculture has been working in partnership with the Indonesian Ministry of Agriculture to improve the management of emerging infectious diseases. The Australia Indonesia Partnership for Emerging Infectious Diseases is funded by the Australian Government, with A$22 million allocated to developing a more integrated veterinary service capable of preventing, detecting and controlling important endemic and emerging infectious diseases. Dr Scott-Orr and Dr Donelan agree that the NAQS is doing a great deal of work on rabies surveillance, education and preparedness to prevent its introduction to Australia. They also believe that Australia's ongoing work with neighbouring countries is playing an important part in our protection from the deadly disease. "Spending resources on helping our neighbours control rabies helps reduce the risk to Australia. It also helps build the pool of professionals with experience in fighting an outbreak, " Dr Donelan said. Preventing the spread of rabies is best achieved through vaccination. Dr Scott-Orr says the most universal knee-jerk reaction from authorities is to kill dogs, but this has proven to be ineffective in containing the virus. "In new incursions, it often spreads insidiously for several months in the dog population before one or more human deaths occur, causing panic. The way to control rabies is to vaccinate dogs. The target for control is at least 70% of dogs vaccinated every year with a vaccine that has a 3-year duration of immunity. In addition to this, preventing rapid turnover of the dog population by fertility control is strongly advisable, " Dr Scott-Orr said. • Rabies is a vaccine-preventable viral disease that occurs in more than 150 countries and territories. • Infection causes tens of thousands of deaths every year, mostly in Asia and Africa. • 40% of people who are bitten by suspect rabid animals are children under 15 years of age. • Dogs are the source of the vast majority of human rabies deaths. • Immediate wound cleansing and immunisation within a few hours after contact with a suspect rabid animal can prevent the onset of rabies and death. • Every year, more than 15 million people worldwide receive a post-exposure vaccination to prevent the disease -this is estimated to prevent hundreds of thousands of rabies deaths annually. Within Australia, Dr Donelan is encouraging veterinary practitioners who regularly visit remote communities to provide dog health programs to be more proactive in rabies preparedness. "Relationships are everything in working with Indigenous communities and people who are known, trusted and respected by the locals are far more likely to be given information about sick dogs and gain their cooperation with control measures and vaccination programs, than are outsiders. There is often a healthy mistrust of authority, stemming from experience that usually the prime goal of dog 'management' is to kill the dogs, " Dr Donelan said. Both Dr Scott-Orr and Dr Donelan advise veterinarians to consider getting vaccinated against rabies for personal protection and to enable them to assist in an outbreak if one was to occur. AMRRIC is currently establishing a register of rabies-vaccinated practitioner members currently servicing or prepared to volunteer in northern Australia. "The prevalence of the closely related Australian bat lyssavirus (ABLV) in both flying foxes and some insectivorous bats, with three human and two equine fatalities recorded, presents another reason for Australian vets to consider being vaccinated against rabies. ABLV has been found in all states except Tasmania and the ACT, " Dr Scott-Orr said. The media space is becoming more competitive, with more pressure on fewer journalists to file stories in a shorter space of time and when big stories overtake the news, such as the recent terrorist threat, these pressures intensify. Total times the AVA and its spokespeople feature in the media each year. AVA news is not only covered in print, radio and television but increasingly online as well. In fact, between January and September this year, 17% of our media coverage appeared in online news sites. This reflects people's demand for immediate, up-to-date news and growing preferences to receive information from online sources. You can view some of the online news coverage we've received on the AVA website at www.ava.com.au/news-2. The AVA media program involves identifying and telling positive stories to raise the AVA's profile and promote the veterinary profession. The topics we cover include topical policies, response to disease outbreaks and the advocacy work the AVA does to support our five strategic priorities. An example of coverage from our advocacy work is the higher education reforms campaign where media coverage has supported our efforts to communicate our position to decision makers in person. Significant media coverage was received on this issue. Julia Nicholls conducted several interviews about the impact the reforms would have on veterinary students and the profession. The story was covered in the Sun Herald, the Sunday Age and the Sunday Canberra Times. Flow on coverage included WSFM, 2UE in Sydney, 2EC Bega and 6PR Perth, as well as the Rural Report on ABC online. A successful program of stories throughout the year for many of our special interest groups has helped maintain our media profile. These stories have covered heat waves, tick paralysis, parvovirus, behavioural issues, farm safety, dental health, distemper, heartworm, parvovirus, horse heart murmurs, Hendra virus, BVDV, pollen, snake bites and swooping magpies. You can view all the AVA media releases on the website at www.ava.com.au/mediareleases. AVA members also have regular pet advice columns in the West Australian and the Adelaide Advertiser, and a weekly pet radio segment on 2NM Muswellbrook. Although stories focussing on companion animals tend to be popular with the media, we continue to increase our influence in the rural media and promote the great work veterinarians do with producers and livestock.  45% Pets  24% Livestock  6% Equine  19% Legislation / advocacy  6% Other Media releases have been distributed throughout the year to promote SIG and division conferences. The publicity program for the AVA Annual Conference was a great success this year and generated 551 media hits. One of the biggest drawcards was the media conference on antimicrobial resistance, which generated more than 330 media hits alone, including Radio National and ABC radio stations around Australia. A panel of experts, who presented papers on the topic at the conference, spoke at the media conference about the facts on antimicrobial resistance in animals and the potential impact on people. Although the situation in Australia is better than in many other parts of the world, the take home message was that we can't be complacent. Australia needs a long-term national surveillance program of antibiotic resistance before any problems get out of hand. You can view some of the coverage at Yahoo 7 News (AAP) and ABC Rural. This year's ASAVA conference resulted in a TV news piece on NBN and an interview with David Neck on ABC Brisbane. Several media releases to support the World Buiatrics Congress delivered 25 media impressions in Queensland Country Life, ABC Rural, The Veterinarian and Southern Cross Radio among others. Every year the AVA conducts media training sessions using professional media trainers to ensure we have a pool of spokespeople to cover every division, SIG and potential topic of media interest. We have been very fortunate with the calibre of AVA volunteer spokespeople over the years and they have been instrumental in helping us to achieve such excellent exposure for the profession and the AVA in the media. Comment on this article at www.ava.com.au/13304 Protection against Hendra at equestrian events E quine Veterinarians Australia (EVA) has recently advised members on the best-practice approach to managing Hendra risk at equestrian events. "Managing Hendra biosecurity risk at events is extremely challenging due to the nature of the disease and the large number of horses and people intensively interacting, " said Nathan Anthony, President of EVA. "Event organisers have a responsibility to ensure a safe environment for horses and people. However, not all event organisers are willing or able to implement and adhere to Hendra biosecurity essentials during an equestrian event, " Dr Anthony said. Veterinarians providing services at equestrian events have obligations in relation to work health and safety, and they are expected to provide accurate advice on biosecurity threats. EVA has provided recommendations and resources to help veterinarians meet these obligations. "For events in Queensland and New South Wales, EVA advises organisers to implement a mandatory Hendra vaccination requirement for all event participants. This is to protect both people and horses from the extremely serious effects of an outbreak at an event, " Dr Anthony said. "For events in other states and territories, we advise event organisers to require horses travelling from Queensland or New South Wales to be vaccinated against Hendra virus. "EVA has developed resources to help vets communicate this advice and to ensure that event organisers acknowledge their responsibility to manage the risk of a Hendra outbreak, " he said. A ntimicrobial resistance threatens human and animal health worldwide. Antibiotic Awareness Week Australia (17-23 November) 1 forms part of a global campaign to increase awareness of antimicrobial resistance and to promote responsible use of antimicrobials. The veterinary profession is involved this year through the AVA's strategic priority program 'Fighting antimicrobial resistance' . 2 The veterinary profession has adopted the One Health concept of expanding interdisciplinary collaboration and communications in all aspects of health care for humans and animals. Veterinarians are seen by other health professions and the public as key players in the responsible use of antimicrobials, because of our stewardship over a considerable amount of antimicrobial use in companion and food animal species. Participating in Antibiotic Awareness Week alongside human health professionals is a key way for veterinarians to demonstrate their commitment to working with others to help solve this global crisis. The focus on antimicrobial resistance and use in humans and animals is increasing around the world, and both the World Health Organization 3 and World Organisation for Animal Health 4 (OIE) are leading policy to extend the useful life of antimicrobials. Here in Australia, the departments of agriculture and health are developing a national strategy on antimicrobial resistance similar to Canada, the United States and the United Kingdom. Resistance to antibiotics is found in Australian hospitals 5 and increasingly in the community. Multidrug-resistant bacterial pathogens are becoming more prevalent. Patients with resistant infections experience delayed recovery and treatment failure and are more likely to die than patients with non-resistant infections. The profession and the AVA have been proactive in addressing antimicrobial resistance concerns, naming 'fighting antimicrobial resistance' as one of the AVA's five strategic priorities. Recent new resources have included simple one-page guidelines on the principles of responsible prescribing of antimicrobials by veterinarians and a client fact sheet on safe handling of animals being treated with antibiotics. The AVA is also currently exploring options to develop new national guidelines to help veterinarians ensure they're making the best decisions when prescribing antibiotics. The Australian Veterinary Journal has recently published several articles on antimicrobial resistance and its effect on our patients and ourselves, including articles on methicillin-resistant Staphylococcus aureus (MRSA) in horses, 6 vet hospitals 7 and its carriage by veterinarians. 8 Australia is in an enviable position with regard to antimicrobial resistance -we have never allowed the use of fluoroquinolones in food-producing animals, and a recent survey by Meat and Livestock Australia 9 showed low levels of resistance in Australian beef. Over time, the One Health focus on antimicrobial resistance will increase and it's important that veterinarians are proactively involved and informed of their responsibilities when using antimicrobials in all areas of practice, both companion and food animals. In the future, veterinarians may well be more involved in human cases of antimicrobial resistance. For example, family pets may be identified as reservoirs of infection. 10 Veterinarians may have to make decisions on whether to use the newest 'big gun' antimicrobial or more conservative treatment. Off-label prescribing and compounding practices in food-producing animals may also come under increasing scrutiny. These challenges will provide an opportunity to underscore the importance of veterinary science to the overall health of both humans and animals. Veterinarians are not unique in facing this challenge. More than 4000 health professionals have already taken a pledge to support the MIND ME principles: 11 Microbiology guides therapy wherever possible Indications should be evidence based Narrowest spectrum required Dosage appropriate to the site and type of infection Minimise duration of therapy Ensure monotherapy in most cases. Indeed, clients may come to expect this approach from all health professions, veterinarians included. Jonathan Taylor AMRRIC is an independent group of veterinarians, academics and health professionals, both Indigenous and non-Indigenous, working in the One Health framework to improve the health and well-being of companion animals and their communities. Since its inception, AMRRIC has focused on developing and implementing sustainable, culturally-sensitive programs in rural and remote Aboriginal and Torres Strait Islander communities. This program has seen dozens of veterinarians, nurses and other volunteers from around Australia and overseas donate their time and skills in desexing, worming and treating animals in some of the country's most remote communities. The conference, held in Darwin in conjunction with the International Fund for Animal Welfare (IFAW), attracted over 125 delegates from Australia and around the world. Following a Welcome to Country by Larrakia Elder Bilawara Lee, AMRRIC President Ted Donelan and IFAW regional director, Isabel McCrea, opened proceedings. Keynote speakers included Kate Nattrass Atema, IFAW's Program Director Companion Animals, who discussed the logistics of animal welfare programs in countries ranging from Bosnia to Bali. Dr Frank Ascione, from the University of Denver, has performed extensive research on the link between animal abuse and interpersonal violence. He discussed the relationship between mental health and animal abuse, as well as animal abuse as an indicator of family violence. He also discussed initiatives that had been developed as a result of this research, including pet-friendly shelters for victims of domestic violence. With the threat of a rabies incursion into Northern Australia presenting a real risk to remote communities, the topic of rabies detection and control was a key theme of the conference. A panel of experts, including NT Chief Veterinary Officer Dr Malcolm Anderson, NT Centre for Disease Control Public Health Physician Dr Charles Douglas, Northern Australia Quarantine Strategy Veterinary Officer Joe Schmidt and former NSW Chief Veterinary Officer Helen Scott-Orr, participated in a simulated rabies incursion to assess Australia's preparedness for such an outbreak. Issues raised included the number of vaccinated veterinarians available to assist in such an event, the need for existing relationships with and experience with communities, and understanding of dog population dynamics in remote communities. Above all, the conference provided an opportunity for those working at the coalface to connect with others in academia and government and ensure that community animal health and welfare are on the agenda. "What I have learnt there was very motivating and made me see my community from another perspective, " said Torres Strait Island Regional Council Animal Management Worker, William Bero. "It has motivated me to continue in promoting healthy and happy animals equals healthy and safe community. " The study reaffirms much of what we already know, but it is an Australian study -which is important, as we don't have much local data, " said Dr Andrew Carter, AVA SA Division President. "Interestingly, the study also noted that two-thirds of incidents involved the dog being provoked. This is significant, as it again points to the need for children to be taught about appropriate interaction with pets, but also highlights the need for adults to step in, " Dr Carter said. In regard to breed, the study finds that breed-specific legislation is not necessarily effective and proposes the development of a set of well-defined criteria that enables early identification of dangerous dogs on an individual basis. "This is very much in line with our own AVA research, 3 which emphasises the importance of education coupled with identification and control of individual 'potentially dangerous' dogs along with 'dangerous' dogs, " Dr Carter said. The results mirror another recent study of dog bite-related fatalities in the United States. That study, released late last year, looked at 259 fatalities from 2000 to 2009. 4 Although calculated risk factors could not be specified by the study, the key factors that were found to be present in fatal attacks were: • absence of someone to intervene • the dog and victim were unknown to each other • the dog was not desexed • compromised ability of victims to interact appropriately with dogs • the dogs were isolated from regular positive human interactions (possibly kept outside) • owners' prior mismanagement of dogs • owners' history of abuse or neglect of dogs. Importantly, in the majority of fatalities at least four of these factors were in place. The study reinforced other findings relating to breed, stating that dog bite-related fatalities "were characterized by coincident, preventable factors; breed was not one of these. " 2 The paper also notes that although desexing appeared to be a factor, it is uncertain whether this is causal or coincidental. They note that past research "…suggests that owner failure to have their dog spayed or castrated may co-occur with other factors that more directly influence a dog's social competence. " 2 Executive Officer -SA and NT Division Comment on this article at www.ava.com.au/13308 The results support the existing understanding of dog bite incidents: dog bites are most likely to involve children aged 0-4 years, who are bitten on the face by a familiar dog and in a familiar environment. eSutures is a discount distributor of Ethicon, Covidien, Synthes, Bard and Arthrex suture, mesh and surgical devices. We specialize in selling brand name products at below market prices in quantities YOU decide. We stock thousands of surgical devices available by the box or by the individual item, and ready to ship TODAY! No contracts. No minimum orders. Fast shipping. All orders ship Global Priority from the U.S. at a flat rate. Order Today: info@eSutures.com www.eSutures.com Use promo code: AVJ for $10 off your next order of $50 or more.* A ccording to the Food and Agriculture Organisation of the United Nations (FAO), a recent strain of avian influenza virus in poultry in Southeast Asia needs to be closely monitored. Known as A(H5N6), the FAO says it represents a new threat to animal health, with recent detection in poultry in the Lao PDR and Vietnam after first being reported in poultry in China in April 2014. It also represents a threat to the poultry-related livelihoods that contribute to the incomes of hundreds of millions of people in the region. FAO's Chief Veterinary Officer, Dr Juan Lubroth, said that influenza viruses are constantly mixing and recombining to form new threats. "H5N6 is particularly worrisome as it's been detected in several places so far from one another. And because it's so highly pathogenic, meaning infected poultry become sick and, within 72 hours, death rates are very high, " Dr Lubroth said. The World Health Organisation for Animal Health (OIE), which works together with the FAO and the World Health Organization (WHO) to support countries' responses to animal and human disease threats, is also monitoring the situation closely. Only one case of H5N6 has been reported in humans after contact with exposure to poultry shortly after its detection in China. The person later died. According to the WHO, although the dynamics of the new strain are still not fully understood, it's unlikely that H5N6 represents an immediate and significant threat to human health. Both the WHO and FAO have advised that even if the public health risks posed by H5N6 currently appears to be low, it is still of concern and they recommend that consumers follow appropriate hygiene, food preparation and food safety guidelines. These include washing hands often, cleaning utensils and surfaces used during food preparation and eating only well-cooked poultry meat products. People should also avoid handling sick birds or those that have died of illness. The FAO is also urging countries to remain vigilant to prevent further spread of the virus and is recommending that governments in the area support poultry producers in following essential biosecurity measures and standard hygiene precautions. This includes early detection, immediate reporting and rapid response. Comment on this article at www.ava.com.au/13309 D r Russell Dickens OAM is a trailblazer and mentor to countless young and now a bit older veterinarians. Dr Robert Johnson suggested we shine the AVJ member spotlight on his mentor, Dr Dickens, so we can share his story with AVA members. Dr Dickens started a veterinary practice in Western Sydney in 1960 and has been protecting Australian wildlife and caring for animals, farmers and pet owners ever since. He has seen Western Sydney transition from a rural, farming community to a burgeoning, densely-populated metropolis and has evolved his practice to meet the changing needs of his community. Beyond his practice and research work, Dr Dickens is a primary producer of Angus Beef at Cullen Bullen and has also placed his considerable energy into community activities. He has been a councillor at Blacktown Council for over 30 years, served as Mayor and is currently Deputy Mayor, while still working at his practice. He is a foundation member of the Animal Ethics Committee at Westmead Hospital and Millennium Institute, a Rotary Paul Harris Fellow, on the Salvation Army's Advisory Board and this year was lauded with the University of Sydney's Alumni Award, which places him among some of the sharpest minds in Australia. Dr Johnson recounted a recent Saturday afternoon, when he thought he'd done a stellar day's work after a full week. He finished by 2pm and thought he'd pop in to visit Dr Dickens' practice. "I found a packed waiting room with Russ methodically managing the clients by himself. When he saw the look on my face, he smiled and said, 'I'm also acting Mayor today' , " Dr Johnson recalled. He also still -almost exclusively -runs his practice's out-of-hours service and has done so since the 1960s. "Age is a matter of mind. If you don't mind it doesn't matter, " he quipped. When asked to recall a time he had shared with his mentor that had a particular effect on him, Robert chose to share the aftermath of being sent to help a Friesian cow with a dislocated hip, some 30 years ago. "Russ sent me out to attend to a large heifer and I managed to sedate her, get her to lie down and with the farmer's help and some impressive force, to reduce the dislocation. Triumphant, I headed back to the practice where Russ looked at me with some surprise. I asked, "Why the funny look?" Russ said that he had expected me to be covered from head to toe in mud and to provide him with his entertainment for the afternoon. Like most other days, we laughed. "Russ has taught me the two most important things in my career: that it's fun to be a veterinarian and you should always be prepared to laugh at yourself, " Dr Johnson said. E ach year the AVA recognises those who contribute to and serve the veterinary profession or the Association. Nominations are now open for the following prizes and awards: This is the AVA's most prestigious award for outstanding service by a member or a non-member to veterinary science in Australia. Nominees who were unsuccessful from the previous two years are automatically included. Issued jointly with the Australian College of Veterinary Scientists, the Kesteven Medal is awarded to members for distinguished contributions to international veterinary science through technical and scientific assistance to developing countries. Nominees who were unsuccessful from the previous two years are automatically included. Awarded to members for outstanding service to the Association. The Award is given either to members who have rendered meritorious service to the Association, regional divisions, branches or special interest groups, or to persons who are not eligible for membership of the Association but have clearly provided meritorious service to those bodies. Awarded to eminent non-veterinarians for services to the AVA or the veterinary profession. Animal Health Australia, the Australian Veterinary Association and Guild Insurance have put together a unique framework to cover private practising vets like you to assist in an Emergency Animal Disease Response. No other insurer offers this unique cover. For leading Veterinary Business Insurance and Professional Indemnity Insurance call us today for a quote. Insurance issued by Guild Insurance Ltd (GIL) ABN 55 004 538 863, AFSL 233791 and subject to terms, conditions and exclusions. GIL supports your association through the payment of referral fees. GIL will assess an EADR outbreak and make a decision to provide cover on a case by case basis. GIL will need to be contacted for the cover to be activated. Additional premiums may apply depending on existing cover with GIL. For information on the Guild Veterinary Business Insurance Policy, refer to the Product Disclosure Statement (PDS) and Policy Wording. You can get a copy of the PDS by calling 1800 810 213. GLD2846 AVJ EADR Ad 07/2014 While you're taking care of an emergency, who's taking care of you? Make the right choice. Freecall 1800 810 213 guildinsurance.com.au/eadr D r Alex Rosenwax from Waterloo in Sydney, reports that he has had five unrelated unusual cases of rabbit deaths over the past few weeks. All presented with gastrointestinal stasis and were febrile with anorexia. The signs appeared to be consistent with calicivirus and all died within 6-48 hours, despite intensive treatment. All came from one general area of Sydney, and they had been vaccinated in the past. "I have contacted the DPI and they have confirmed that a new strain of calicivirus has been documented in Sydney by Elizabeth Macarthur Agricultural Institute (EMAI) in the past year. That strain is resistant to the vaccine. Their signs were similar to the ones in the rabbits we have seen, " said Dr Rosenwax. Rabbit haemorrhagic disease virus (RHDV) is a calicivirus that usually kills 95% of susceptible adult rabbits within 72 hours, but the molecular mechanisms for this virulence are unknown. It has been used in Australia as a biological control agent to reduce rabbit numbers since it was released in 1995. There is also an endemic non-pathogenic Australian rabbit calicivirus, RCV-A1, that is known to provide some cross-protection to lethal infection with RHDV, and pet rabbits are usually vaccinated against the endemic strain to protect them. Australia's Chief Veterinary Officer, Dr Mark Schipp, notified OIE of the new strain in January this year. 1 The notification related to the outbreak in Sydney where sudden deaths occurred in show rabbits of various ages and both sexes. There were very few clinical signs prior to death. The rabbits had previously been in good health and were vaccinated against the endemic strain of rabbit calicivirus. Of the 80 susceptible rabbits, there were 35 cases, and 30 deaths, equating to an apparent morbidity rate of 43.8%, mortality rate of 37.5%, and case fatality rate of 85.7%. Gross necropsy findings showed little signs of the heavy haemorrhage usually seen with RHDV. They had more cranial changes. EMAI reported that the normal ELISA test for calicivirus was negative whereas PCR was positive. Some of the rabbits were presented to Dr Rosenwax because they were apparently having seizures. He noted that although his cases were highly suspicious of calicivirus, as the appropriate samples had not been taken, the cases could not be confirmed. A nonformalin-fixed, frozen 1-g liver sample is required for submission to EMAI to confirm the presence of the virus. Tracing and surveillance of the new strain is underway to determine how many rabbits have been exposed and how widespread the virus is. This may have implications for pet rabbits, as evidence suggests the current vaccine may not be effective against this new strain. This new strain also has implications for rabbit control. The Invasive Animal Cooperative Research Centre (IA CRC) research shows that Australian native vegetation is very sensitive to rabbit damage, and as few as 0.5 rabbits per hectare can remove all seedlings of the more palatable native trees and shrubs, so delaying natural regeneration. 2 Rabbits are Australian agriculture's most costly pest animal with the annual cost of over $200 million. According to the IA CRC, the use of myxomatosis and calicivirus is still limiting rabbit numbers and without them, the annual cost to agriculture from the imported pest would exceed $2 billion. 2 However, they report that rabbit numbers are increasing, with research also showing there are a number of rabbit colonies that are immune to the calicivirus. Without this virus, other control techniques would need to be tried, including warren ripping, fumigating, shooting and baiting. The IA CRC is now involved in studies to evaluate other RHDV strains, mainly because there is increasing genetic resistance in the rabbits to current RHDV strains and young rabbits are acquiring immunity. Dr Rosenwax reports that in the absence of a definitive diagnosis, his practice has instituted quarantine for all rabbits with suspicious clinical signs. We heard about the contrasting aspects of rural practice in three different areas of Australia. All seemed to share similar problems of beef and dairy profitability, increased numbers of graduating veterinarians, competition from paraprofessionals, the cost of travel and the loss of populations from rural towns. David Petersen from Deniliquin, told us about his practice in the dairy area of the Riverina in Victoria. There is no water except for irrigation -the gates on the channels are opened at the top levels, and the water 'wooshes' down for about 4 hours per day. They see American Holstein cattle, which are big cows with lots of milk, that have poor reproductive function, in an area where daytime temperatures are regularly between 40 and 45ºC, and 30ºC at 4am. The veterinarians keep temperature logs in their cars, and have to throw away medications if they get too hot. Sam McMahon told us of her experiences in setting up the Northern Territory Veterinary Services in Katherine. With an area of 1.35 million km 2 , slightly bigger than NZ, UK, Ireland and France combined, but with a population of only 218,000, they need a fleet of 4WD to cover the area. Their practice includes going out to stations and Indigenous communities and their new branch in Alice Springs is a 14.5 hour road trip away from their main centre. Brahman cattle are most common in the humid Katherine, and British cattle breeds in the drier Alice Springs area. Comment on this article at www.ava.com.au/13313 Workshop host Bill Tranter's practice covers 700 km to the north, south and west, with two small animal and equine practices in Mareeba. They cover extensive beef in the west of the region as well as herd health management for the more intensive dairy industry. The practice is an integral part of clinical training at James Cook University. Our first visit was to a relatively small feedlot, with heat-tolerant Brahman-cross cattle. The property has 1.5 metres of rain annually, and also produces silage. The next stop was at a dairy of between 360 and 400 Holstein cows. The tropical grasses grow very slowly except for a flush when it rains in December. They have a year-round calving pattern, and have to produce the same amount of milk throughout the year. Their best conception rates are in the cooler winter months, and they also produce silage and grow ryegrass to boost production at that time. Bull and heifer reproductive examination was next, with Andrew Hoare demonstrating the ultrasound probe and showing us ovarian anatomy, and Enoch Bergman demonstrating the intimacies of bull examination. Andrew Hoare multitasking I wasn't the only one taking photos Communicationthe essential ingredient W ith the increasing amount of technology changing the way we communicate, it can be difficult to find the best medium to engage with all of your stakeholders. Despite all these advancements, in particular the role of the internet, text messaging and social media in our lives, there is still no replacement for verbal communication in a work environment. It is verbal communication that is the essential ingredient in building an efficient and harmonious workplace. The key to an efficient workplace is to create an environment that is conducive to open and honest communication. This creates a positive relationship between employee and employer and while this relationship remains positive, then the workplace will usually stay productive. Most issues with employees can be resolved through a face-to-face discussion where both parties are able to voice concerns, resolve misunderstandings and get a clear understanding of each party's motivations and the solutions required to overcome any grievances. Communication is a two-way process. It involves both the dissemination of information, but even more importantly, the receipt of information through genuine listening. Both are equally important for the employee and the employer. Firstly, managers need to explain to employees what is expected of them and not simply rely on job descriptions to explain this. Employees also have an obligation to ask questions if they are unsure about work requirements and advise managers of any changes that may affect the way they perform the job, or improve the process to deliver expected outcomes. It has often been said that the employment relationship is similar to a marriage. Both parties enter into the relationship with the best of intentions, but throughout the relationship there will be good and bad times, which put the relationship to the test. Once communication becomes difficult, or either party looks for ways to avoid verbal communication, it is a strong sign that there is a problem. The only way to resolve these problems is to address them as soon as the issue is identified and do this face-to-face. Just because an employee chooses to communicate via text, it is never a good idea for a manager to start texting anything more than confirming receipt of the message. It is always best to make a phone call and talk to the employee directly. There can never be too much communication. Managers do not have to wait for that annual review, or monthly meeting, to raise a concern or discuss a matter with their employees on any matter. Frequent communication on any matter will assist in building relationships. Communication must be kept simple and relevant with employees -don't start communicating information that does not affect the employee. Importantly, effective communication does not mean gossiping about an employee's personal life; it simply means communicating what is expected of employees and issues that might be affecting their performance and the effect on other stakeholders. In summary, there are three things that are critical to build an efficient workplace ... communication, communication, communication. If you do this well, you will reduce and avoid most workplace relations issues. Michelle Eamer AVA HR Advisory Service Comment on this article at www.ava.com.au/13314 The material contained in this article is general comment and is not intended as advice on any particular matter. No reader should act or fail to act on the basis of any material contained herein. The material contained in this publication should not be relied on as a substitute for legal or professional advice on any particular matter. Suicidal behaviour and psychosocial problems in veterinary surgeons: a systematic review Veterinary surgeons and suicide: a structured review of possible influences on increased risk The role of veterinary team effectiveness in job satisfaction and burnout in companion animal veterinary clinics References 1. NOBANIS. Invasive alien species fact sheet: -Aphanomyces astaci. www.nobanis.org The effects of crayfish plague on Finland's crayfish economy Australian fisheries statistics 2012 Manual of diagnostic tests for aquatic animals 2012 Cultured aquatic species information programme: Procambarus clarkii (Girard, 1852) The crayfish plague pathogen can infect freshwater-inhabiting crabs Defence reactions in and susceptibility of Australian and New Guinean freshwater crayfish to European-crayfish-plague fungus Event summary: crayfish plague (Aphanomyces astaci) Australian Government Department of Agriculture, Fisheries and Forestry. Identification field guide to aquatic animal diseases of significance to australia. 4th edn. www.daff.gov.au/animal-plant-health/pests-diseases-weeds/ aquatic-animal-diseases-significant-to-australia-identification-field-guide Australian Government Department of Agriculture, Fisheries and Forestry. AQUAVETPLAN disease strategy manual for crayfish plague World Organisation for Animal Health. OIE manual of diagnostic tests for aquatic animals. www.oie.int/international-standard-setting/aquaticmanual/access-online/ Accessed Conservation of freshwater crayfish in Australia Australian Commission on Safety and Quality of Health Care. Antibiotic Awareness Week Australian Veterinary Association. Fighting antimicrobial resistance International Organisation for Animal Health, OIE. Managing antimicrobials use in animals Emergence of multi-resistant Pseudomonas aeruginosa in a Western Australian hospital Methicillin-resistant Staphylococcus aureus in a population of horses in Australia Methicillin-resistant Staphylococcus aureus: an issue for veterinary hospitals Carriage of methicillin-resistant Staphylococcus aureus by veterinarians in Australia Antimicrobials and the cattle industry Methicillin-resistant Staphylococcus aureus in a family and its pet cat NPS MedicineWise: resistance fighter pledge First-time study of Women's and Children's Hospital bite victims shows that nine in 10 attacks is by a familiar dog Retrospective review of dog bite injuries in children presenting to a South Australian tertiary children's hospital emergency department Policy and model legislative framework Co-occurrence of potentially preventable factors in 256 dog bite-related fatalities in the United States Rabbit haemorrhagic disease Invasive animals Cooperative Research Centre. 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