Antibiotic resistance through the lens of One Health: A study from an urban and a rural area in Sri Lanka.

This study aimed to investigate and compare the proportion of AMR Escherichia coli (E. coli) between urban (Dompe in the Western province) and rural (Dambana in the Sabaragamuwa province) areas in Sri Lanka. The overall hypothesis of the study is that there is a difference in the proportion of AMR E. coli between the urban and the rural areas. Faecal samples were collected from healthy humans (n = 109), dairy animals (n = 103), poultry (n = 35), wild mammals (n = 81), wild birds (n = 76), soil (n = 80) and water (n = 80) from both areas. A total of 908 E. coli isolates were tested for susceptibility to 12 antimicrobials. Overall, E. coli isolated from urban area was significantly more likely to be resistant than those isolated from rural area. The human domain of the area had a significantly higher prevalence of AMR E. coli, but it was not significantly different in urban (98%) and rural (97%) areas. AMR E. coli isolated from dairy animals, wild animals and water was significantly higher in the urban area compared with the rural area. There was no significant difference in the proportion of multidrug resistance (MDR) E. coli isolated from humans, wild animals and water between the two study sites. Resistant isolates found from water and wild animals suggest contamination of the environment. A multi-sectorial One Health approach is urgently needed to control the spread of AMR and prevent the occurrences of AMR in Sri Lanka.

A cranial approach to transplastron coeliotomy and gastrotomy performed in a Sri Lanka Black Turtle (Melanochelys trijuga thermalis): Case Report.

Successful transplastron coeliotomy via a temporary cranial plastron osteotomy can be conducted in turtles to remove foreign bodies lodged in the stomach, using basic equipment. A year later, the turtle was returned to the wild indicating that major surgeries with complete recovery can be achieved in this species.

Exploring Barriers to One Health Antimicrobial Stewardship in Sri Lanka: A Qualitative Study among Healthcare Professionals.

Antimicrobial resistance (AMR) is a global health threat, but little is known about the perceptions regarding antimicrobials and AMR among healthcare professionals in Sri Lanka. This research aimed to take a One Health approach to explore the knowledge, attitudes and perceptions of antibiotic stewardship and AMR among healthcare professionals in Sri Lanka. A qualitative study, using telephone interviews, allowing for an in-depth exploration of attitudes, beliefs and perspectives was conducted. Healthcare professionals from both the medical and veterinary sectors were included (n = 29). Interviews were conducted by an independent interviewer and were audio-recorded and transcribed. Conventional qualitative content analysis was undertaken. Four main categories were identified: (1) understanding of AMR and observing AMR, (2) barriers to antimicrobial stewardship, (3) personal factors in, and as a result of, inappropriate antibiotic usage and (4) how to tackle AMR. Healthcare professionals showed poor awareness regarding the spread of AMR and identified inappropriate prescribing behaviours by their inter- and intra-professional colleagues. Patient demands and the influence of pharmaceutical companies were factors contributing to poor prescribing behaviour. Suggestions for the future are stricter regulation of AMR control policy, effective government involvement, and awareness campaigns for healthcare professionals and the public.

Misconceptions of Antibiotics as a Potential Explanation for Their Misuse. A Survey of the General Public in a Rural and Urban Community in Sri Lanka.

Reducing the growth of antimicrobial resistance (AMR) through public understanding is a goal of the World Health Organization. It is especially important in countries where antibiotics are widely available for common ailments without prescription. This study assessed understanding of antibiotics and AMR alongside perception of antibiotic usage among the general public in two diverse Sri Lankan communities: ordinary urban and indigenous rural. A cross-sectional questionnaire survey was conducted, gaining 182 urban and 147 rural responses. The majority of urban respondents (69.2%) believed that they had very good or good knowledge about antibiotics compared to 40.1% of rural respondents. Belief about knowledge and actual knowledge (measured via a test question) were correlated (r = 0.49, p = 0.001) for rural respondents, but not for urban respondents. Several misconceptions about antibiotics were highlighted, including that Paracetamol, a painkiller, was thought to be an antibiotic by more than 50% of both urban and rural respondents. In addition, 18.5% of urban and 35.4% of rural participants would keep and re-use what they perceived as leftover antibiotics. It is urgent that we pay attention to educating the general public regarding the identified misconceptions of these powerful drugs and their appropriate use.

Antimicrobial Resistance Patterns of Fecal Escherichia coli in Wildlife, Urban Wildlife, and Livestock in the Eastern Region of Sri Lanka, and Differences between Carnivores, Omnivores, and Herbivores.

Antimicrobial resistance (AMR) is a major public health concern. We identified AMR in fecal Escherichia coli of wildlife (WL), urban wildlife (UWL), and livestock in the eastern region in Sri Lanka and compared the prevalence of AMR bacteria from carnivores, omnivores, and herbivores. Fecal samples were collected from 165 animals: WL (n=47), UWL (n=54), and livestock (n=64). Esherichia coli was cultured from 129 samples, with isolation rates of 76% from WL (36/47), 70% from UWL (45/54), and 75% from livestock (48/64). Testing E. coli isolates against 12 antimicrobials using the disk diffusion method revealed that the proportions of E. coli isolates resistant to at least one antimicrobial were WL 52.7%, UWL 20%, and livestock 52%. Multidrug-resistant E. coli isolates were detected in WL, UWL, and livestock. Overall, the prevalence of E. coli isolates with AMR was significantly lower in UWL compared with WL and livestock. The number of isolates showed AMR was significantly higher in E. coli from carnivores than in isolates from omnivores and in herbivores. We conclude that AMR E. coli in Sri Lanka is widespread in WL, UWL, and livestock. The higher incidence of AMR bacteria in carnivores compared with herbivores and omnivores suggest that the mechanisms of spread of AMR may vary among wild animals, which requires further investigation.

Developing a non-invasive method of detecting elephant endotheliotropic herpesvirus infections using faecal samples.

BACKGROUND: Elephant endotheliotropic herpesvirus (EEHV)-associated haemorrhagic disease (EEHV-HD) is a leading cause of death in Asian elephant calves across the world. Cases of EEHV-HD have been detected in free-living calves through post-mortem examination (PME) indicating the presence of the virus in the wild. In the absence of a non-invasive sampling method, little research into free-living populations has been possible. This study aimed to provide evidence that faeces can be used as a non-invasive sampling method for the detection of EEHV excretion using quantitative polymerase chain reaction. METHODS: Serial saliva swabs and faecal samples were taken from five captive Asian elephants in Thailand over 12 weeks. To ensure the presence of detectable elephant DNA within the sample, qPCR was run for amplification of the Asian elephant tumour necrosis factor (TNF-α) gene, EEHV1 and EEHV4. RESULTS: Of 28 sample pairs, seven saliva samples were positive for EEHV, of which two had paired positive faecal samples. CONCLUSIONS: This study presents the first evidence that EEHV is excreted in faeces at detectable levels. This method may in future be used for improved understanding of the epidemiology of EEHV in free-living elephant populations, as well as detection of EEHV excretion in captive herds.

Characterization and Antimicrobial Resistance of Environmental and Clinical Aeromonas Species Isolated from Fresh Water Ornamental Fish and Associated Farming Environment in Sri Lanka.

The aims of this study were to characterize and investigate antimicrobial susceptibility and presence of integrons in 161 Aeromonas spp. isolated from ornamental freshwater fish farming environment, apparently healthy and diseased fish. Phylogenetic analyses of the gyrB gene sequences identified Aeromonas veronii as the most abundant species (75.8%) followed by Aeromonashydrophila (9.3%), Aeromonas caviae (5%), Aeromonas jandaei (4.3%), Aeromonas dhakensis (3.7%), Aeromonas sobria (0.6%), Aeromonas media (0.6%), and Aeromonas popoffii (0.6%). Susceptibility to thirteen antimicrobials was determined and antimicrobial resistance frequencies were: amoxicillin (92.5%), enrofloxacin (67.1%), nalidixic acid (63.4%), erythromycin (26.1%), tetracycline (23.6%), imipenem (18%), trimethoprim-sulfamethoxazole (16.8%), and gentamicin (16.8%). Multi-drug resistance (MDR) was widespread among the isolates (51.6%, 83/161) with 51.6% (63/122) A. veronii isolates being MDR. In addition, 68.3% of isolates had multiple antibiotic resistance (MAR) indexes higher than 0.2, suggesting that they originated from a high-risk source of contamination where antimicrobials are often used. In all, 21.7% isolates carried class 1 integrons, with 97.1% having gene cassettes, while there were 12 isolates carrying class 2 integron gene cassettes. Our findings highlight that the aquatic environment and ornamental fish act as reservoirs of multidrug resistant Aeromonas spp. and underline the need for a judicious use of antimicrobials and timely surveillance of antimicrobial resistance (AMR) in aquaculture.

Effect of Tourist Activities on Fecal and Salivary Glucocorticoids and Immunoglobulin A in Female Captive Asian Elephants in Thailand.

Asian elephants have been an important part of wildlife ecotourism in Thailand for over two decades. Elephants in tourist camps are exposed to a variety of management styles and daily activities that can potentially affect health and welfare. This study investigated relationships between a novel welfare biomarker, immunoglobulin A (IgA), and daily camp activities, and compared results to glucocorticoid (GC) measures. Often no-riding camps are portrayed as providing better welfare than camps that offer riding. Therefore, we predicted that elephants at no-riding camps would have lower GC and higher IgA concentrations, and a low GC/IgA ratio. Forty-four female elephants from six elephant camps were divided into three groups based on riding activities: saddle-riding, bareback-riding, and no-riding. Fecal and salivary samples were collected monthly for 1 year along with evaluations of body condition, foot health, and wounding. Camp environment and management varied among camps, although the major difference was in riding activities. Concentrations of GCs and IgA varied among the working groups, but not always consistently between sample matrices. Overall fecal glucocorticoid metabolite concentrations were lowest in the saddle-riding group. Only in one bareback-riding camp did the elephants exhibit a potentially positive welfare response with a low GC/IgA ratio over time. Other results varied between the two biomarkers, with considerable variability across camps, suggesting there is more to good welfare than whether elephants participate in riding or not. Several other human-induced stressors, like chaining, ankus use, and limited social opportunities are likely to be impacting well-being and should be considered to ensure management practices meet physical and psychological welfare needs.

Circadian Rhythm of Salivary Immunoglobulin A and Associations with Cortisol as A Stress Biomarker in Captive Asian Elephants (Elephas maximus).

Salivary immunoglobulin A (sIgA) has been proposed as a potential indicator of welfare for various species, including Asian elephants, and may be related to adrenal cortisol responses. This study aimed to distinguish circadian rhythm effects on sIgA in male and female Asian elephants and compare patterns to those of salivary cortisol, information that could potentially have welfare implications. Subjects were captive elephants at an elephant camp in Chiang Mai province, Thailand (n = 5 males, 5 females). Salivette® kits were used to collect saliva from each elephant every 4 h from 06:00 to 22:00 h for 3 consecutive days (n = 15 samples/elephant). Enzyme immunoassays were used to quantify concentrations of IgA and cortisol in unextracted saliva. Circadian rhythm patterns were determined using a generalized least-squares method. Both sIgA and cortisol followed a circadian rhythm, although the patterns differed. sIgA displayed a daily quartic trend, whereas cortisol concentrations demonstrated a decreasing linear trend in concentrations throughout the day. There was no clear relationship between patterns of sIgA and salivary cortisol, implying that mechanisms of control and secretion differ. Results demonstrate for the first time that circadian rhythms affect sIgA, and concentrations follow a daily quartic pattern in Asian elephants, so standardizing time of collection is necessary.

Discipline-Specific Compared to Generic Training of Teachers in Higher Education.

A recurrent theme arising in the higher education sector is the suitability and effectiveness of generic versus discipline-specific training of university teachers, who are often recruited based on their disciplinary specialties to become teachers in higher education. We compared two groups of participants who had undergone training using a generic post-graduate certificate in higher education (PGCertGeneric) versus a discipline-specific course in veterinary education (PGCertVetEd). The study was conducted using a survey that allowed comparison of participants who completed PGCertGeneric (n=21) with PGCertVetEd (n=22). Results indicated that participants from both PGCertGeneric and PGCertVetEd considered teaching to be satisfying and important to their careers, valued the teaching observation component of the course, and identified similar training needs. However, the participants of the PGCertVetEd felt that the course made them better teachers, valued the relevance of the components taught, understood course design better, were encouraged to do further courses/reading in teaching and learning, changed their teaching as a result of the course, and were less stressed about teaching as compared to the PGCertGeneric participants (p<.05). It is likely that the PGCertVetEd, which was designed and developed by veterinarians with a wider understanding of the veterinary sector, helped the participants perceive the training course as suited to their needs.

Student experiences and perceptions of compulsory research projects: a veterinary perspective.

BACKGROUND: Although research underpins clinical work, many students training to be clinicians are not inherently interested in developing research skills. AIM: To characterise and understand veterinary student experiences and perceptions of compulsory research projects. METHODS: This was an explanatory sequential mixed-methods study, with a questionnaire survey of an entire cohort informing purposive selection for focus group discussions. Student views were triangulated with staff questionnaire data. RESULTS: About a third of the cohort felt that the project had not been worthwhile or had not fostered useful skills. Focus group data analysis identified fragility of motivation and lack of clear schemata for the research process as key themes. Students were easily demotivated by typical research challenges and lack of schemata contributed to a poor understanding of the rationale for the project, encouraging highly extrinsic forms of motivation. Triangulation with staff questionnaire data indicated that staff understood students' challenges, but were more likely than students to consider it to be a valuable learning experience. CONCLUSIONS: Findings support ongoing curriculum development and emphasise that, to optimise motivation, engagement and learning, students training to be clinicians need a clear rationale for research, based on development of critical inquiry skills as a core clinical competency.

Nocturnal behavior of orphaned Asian elephant (Elephas maximus) calves in Sri Lanka.

Many animals exhibit circadian variation in behavior; thus, studying nocturnal behavior is important to fully understand species activity patterns. The nocturnal behavior of Asian elephants, and specifically calves, has received little previous study. We carried out observational study of the nocturnal behavior of orphaned Asian elephant calves at three age groups: "infant" (0-24 months), "young juvenile" (25-36 months) and "old juveniles" (over 36 months). Project aims were to build a nocturnal activity budget, to investigate key age differences, and whether calves exhibited synchronous behavior patterns. We carried out focal animal sampling and instantaneous group scan sampling on 34 calves for 18 nights using an infra-red camera. Focal results indicated that calves spent the highest percentage of scans in lying rest (46.2%) and feeding (28.4%). There was no significant difference between lying rest in the three age groups. Calves spent the majority of time within 5 m of their nearest neighbor, with infants remaining in closest proximity to conspecifics compared to older calves. Synchronous behavior could not be proved statistically but two distinct lying rest periods between 2300 and 0100, and 0330 and 0530, were noted. We found that calves spent more time in lying rest than previously observed in adult elephants. Activity patterns observed suggest that the orphaned group behavior is similar to that reported in the wild and captive zoological collections, and appears to be in concordance with "natural" behavior patterns, a defining feature of animal welfare. This research provides valuable data as a preliminary study.

Scaffolded Active Learning: Nine Pedagogical Principles for Building a Modern Veterinary Curriculum.

Veterinary discipline experts unfamiliar with the broader educational literature can find the adoption of an evidence-based approach to curriculum development challenging. However, greater societal and professional demands for achieving and verifying Day One knowledge and skills, together with continued progress in information generation and technology, make it all the more important that the defined period for initial professional training be well used. This article presents and discusses nine pedagogical principles that have been used in modern curricular development in Australia, the United Kingdom, and the United States: (1) outcomes-based curriculum design; (2) valid and reliable assessments; (3) active learning; (4) integrated knowledge for action; (5) tightly controlled core curriculum; (6) "just-in-time" rather than "just-in-case" knowledge; (7) vertical integration, the spiral curriculum, and sequential skills development; (8) learning skills support; and (9) bridges from classroom to workplace. Crucial to effective educational progress is active learning that embraces the skills required by the modern professional, made possible by tight control of curricular content. In this information age, professionals' ability to source information on a "just-in-time" basis to support high quality reasoning and decision making is far more important than the memorization of large bodies of increasingly redundant information on a "just-in-case" basis. It is important that those with responsibility for veterinary curriculum design ensure that their programs fully equip the modern veterinary professional for confident entry into the variety of roles in which society needs their skills.

Diet composition, food intake, apparent digestibility, and body condition score of the captive Asian elephant (Elephas maximus): a pilot study in two collections in Thailand.

Limited data are available regarding the nutrition and feeding of captive Asian elephants in range countries. In this study, feeding regimens of two collections in northern Thailand and their actual diets shaped by availability of forage and mahout preferences were assessed for nutritional quality. The composition of dietary intake, fecal output, and the dietary regimen were individually recorded for 5 days in 10 elephants. The proportion of forage in the diet represented 41 to 62% of the dry matter intake (DMI) in one collection whereas in the other collections it varied between 68 and 72%. Between 8.5 and 24% of the diet consisted of commercial pellets, and hulled rice represented up to 25% of the DMI in one collection. Sugar cane, corn cobs, and fruits such as bananas were eaten in smaller amounts. Body condition scores and weights were measured, which revealed that nine animals were in good condition. Representative samples of each food as well as fecal samples were analyzed for dry matter, crude protein, fat, crude fiber, gross energy, ash, calcium, and phosphorus. Diet adequacy was assessed by calculating the digestible nutrients in the rations and by comparing them to the recommendations from literature. The digestible energy (DE) intake varied between 0.6 and 1.4 megajoules (MJ) per kg(0.75) per day; therefore, higher than the estimated recommendations of 0.65 MJ per kg(0.75) per day for nine of the elephants. In all elephants the crude protein intake was less than the maintenance recommendations and ranged between 6.01 and 7.56% of the DMI. Calcium intake was low in one collection and there was an inverse calcium: phosphorus ratio, which was inadequate. The present study adds to the knowledge of captive elephant diets in Asia and is a starting point for further research, which is necessary to design optimum diet plans for captive Asian elephants in Thailand.

Teacher development: a patchwork-text approach to enhancing critical reflection in veterinary and para-veterinary educators.

Reflection is an essential component of teacher-development programs, and reliable, valid methods to teach, assess, and evaluate reflection are critical. However, it is important that appropriate methods are created for and evaluated across multiple disciplinary backgrounds, as the participants' backgrounds are a major factor in the development of critical reflection. The patchwork-text approach is a narrative process that is predominantly focused on the personal development of the individual. The current study used the patchwork-text approach for the development of reflection in participants with a science background who had not used a reflective approach for personal development before. Twenty summative essays and 103 formative essays from 21 participants who underwent a 1-year higher-education teacher-development program were analyzed to assess whether the quality and quantity of reflective writing was enhanced through a regular, iterative process of reflective writing with feedback. The analysis of the essays involved the use of a predefined set of criteria for identifying the different reflective levels from 1 to 4 and the calculation of a reflective score to evaluate the overall development. The results show a clear improvement of higher-level critical thinking as the participants progressed through their course. Higher levels of reflection were achieved particularly where a unit focused on a familiar area for the participant as opposed to one in which the participant had less experience. The analysis provides evidence that the patchwork text is a useful method for development and evaluation of reflection in participants with a veterinary/animal-science base.

The development of a new methodology for knowledge sharing in the interface between university and society--an example from the meat sector.

Design science research was used for the generation, use and evaluation of a model for knowledge sharing in the user community through open educational resources (OER). The focus of interest was on the development process of a model for knowledge sharing that emphasizes the characteristics and the needs of the user community; the empowerment and democratic issues of openness; the collaboration between institutions and dialog with society; and the consideration of quality and sustainability issues. Initially, the community needs were analyzed through surveys and workshops, and the findings used, through negotiations, to formulate the development process. An open-training platform served as an infrastructure and included a repository with OER, a wiki and a discussion forum. The purpose of this article is an attempt to provide universities with a plan and template for integrated knowledge sharing that responds to societal needs. Usability and usefulness has not been evaluated.

Ultrasonographic anatomy of the Asian elephant (Elephas maximus) eye.

Bilateral transpalpebral ultrasonography was performed on 53 captive Asian elephants (Elephas maximus) in order to describe the normal ultrasonographic appearance and measurements of the Asian elephant eye. Transpalpebral ultrasonography was performed using a portable ultrasound unit and a 4-7-MHz broadband curvilinear transducer on animals housed at seven institutions in the United Kingdom and in Sri Lanka. Both males and females were included in the study and ages ranged from 14 mo to 65 yr. Ultrasonic examinations were conducted on unsedated animals, without the use of topical or local anesthesia. The ultrasonographic appearance of the globe and intraocular structures of the Asian elephant eye is similar to that in other species. Biometry measurements recorded for adult (n=41) and juvenile (n=10) Asian elephants were: axial length, 3.44 +/- 0.21 cm and 3.18 +/- 0.19 cm (mean +/- SD); equatorial diameter, 3.88 +/- 0.32 cm and 3.60 +/- 0.24 cm; corneal thickness, 0.17 +/- 0.02 cm and 0.16 +/- 0.02 cm; anterior segment depth, 0.45 +/- 0.08 cm and 0.36 +/- 0.07 cm; lens diameter, 1.90 +/- 0.14 cm and 1.75 +/- 0.19 cm; lens depth, 1.01 +/- 0.12 cm and 0.94 +/- 0.10 cm, and posterior segment depth, 1.82 +/- 0.17 cm and 1.72 +/- 0.15 cm, respectively. Multiple linear regression analysis indicated a significant relationship between the explanatory variables (age, sex, and height) and the dependent variables (axial length, equatorial diameter, corneal thickness, anterior segment depth, lens diameter, and lens depth). The main finding of this statistical test was that the globe increases in size as the animal ages. Transpalpebral ultrasonography was found to be an effective and practical imaging modality in the evaluation of the Asian elephant eye, without the need for chemical restraint.

False aneurysms in carotid arteries of cattle and water buffalo during shechita and halal slaughter.

It has previously been shown that the cattle brain is supplied with blood via a basi-occipital plexus, in addition to branches from the carotid and basilar arteries. In addition it has been shown during conventional stunning and slaughter that the carotid arteries in cattle can develop false aneurysms at their severed ends and this can curtail exsanguination. This investigation examined whether false aneurysms can occur during religious slaughter, and during bleeding following electrical stunning that simultaneously induced a cardiac arrest. The prevalence of large (>3cm outer diameter) false aneurysms in cattle carotid arteries was 10% for both shechita and halal slaughter. The prevalence of animals with bilateral false aneurysms (at least 2cm in one artery and at least 3cm diameter in the opposite artery) was 7% and 8% for shechita and halal slaughter, respectively. No false aneurysms occurred during bleeding in cattle that were electrically stunned and simultaneously developed a cardiac arrest. The combination of false aneurysms and collateral routes to the brain present a risk of sustained consciousness during religious slaughter in cattle.