Background The purpose of this review is to systematically appraise the peer-reviewed literature about the genetic and environmental determinants of psychiatric comorbidity, focusing on four of the most prevalent types of psychopathology: anxiety disorders, depression, conduct disorder and substance abuse. Methods We summarize existing empirical research on the relative contribution that genetic, nonshared and shared environmental factors make to the covariance between disorders, and evidence about specific genes and environmental characteristics that are associated with comorbidity. Results 94 articles met the inclusion criteria and were assessed. Genetic factors play a particularly strong role in comorbidity between major depression and generalized anxiety disorder or posttraumatic stress disorder, while the non-shared environments makes an important contribution to comorbidity in affective disorders. Genetic and non-shared environmental factors also make a moderate-to-strong contribution to the relationship between CD and SA. A range of candidate genes, such as 5HTTLPR, MAOA, and DRD1-DRD4, as well as others implicated in the central nervous system, has been implicated in psychiatric comorbidity. Pivotal social factors include childhood adversity/ life events, family and peer social connections, and socioeconomic and academic difficulties. Limitations Methodological concerns include the use of clinical case-control samples, the focus on a restricted set of individual-level environmental risk factors, and restricted follow-up times. Conclusions Given the significant mental health burden associated with comorbid disorders, population-based research on modifiable risk factors for psychiatric comorbidity is vital for the design of effective preventive and clinical interventions.

Panola Mountain Ehrlichia (PME) has been suggested as an emerging pathogen of humans and dogs. Domestic goats and white-tailed deer (Odocoileus virginianus) are also susceptible and likely serve as reservoirs. Experimentally, both the lone star tick (Amblyomma americanum (L.)) and the Gulf Coast tick (Amblyomma maculatum Koch) can transmit PME among deer and goats. In the current study, we detected PME in adult wild-caught A. maculatum from the United States and Amblyomma variegatum (F.) from the Caribbean and Africa. This significantly expands the range, potential tick vectors, and risk for exposure to PME.

BackgroundAs usage of digital information and communication technologies continues to grow, the incorporation of telehealth and telemedicine has become a topic of interest in the veterinary industry. Veterinary telemedicine presents the opportunity to expand veterinary medicine by increasing access to healthcare services for clients and patients and improving medical quality. The objective of this study was to assess veterinarians’ knowledge and utilization of telehealth and telemedicine.ResultsSeventy-six veterinarians participated in the study and both qualitative and quantitative analyses were performed on the data collected. Several key themes emerged from the qualitative analysis of open-ended questions, including telecommunication, Doctor of Veterinary Medicine (DVM)-patient services, and remote interaction, among others. Through coding and qualitative analysis, researchers identified a lack of knowledge of the American Veterinary Medical Association (AVMA) definitions of telehealth and telemedicine. Specifically, a notable amount of participants were unaware of the distinction between the two practices per AVMA guidelines. Quantitative analyses revealed that the largest group of respondents reported sometimes utilizing telehealth and telemedicine in practice, with no distinct difference in utilization among the different age demographics of participants.ConclusionsThese observations indicate a need for interventions both in veterinary school and continuing education programs with the purpose of increasing both knowledge and utilization of telehealth and telemedicine among veterinarians. While these recommendations serve as a starting point, future studies are needed to further enhance the understanding of veterinary telehealth and telemedicine in practice.

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Veterinary students across the United States face the challenge of stress during school every day. When managed improperly, stress can become chronic and manifest in physical and emotional consequences. The purpose of this study was to examine the utility of the multi-theory model (MTM) of health behavior change in predicting the initiation and sustenance of stress management behaviors among veterinary students. A cross-sectional design was used to study the efficacy of the MTM in predicting initiation and sustenance of stress management behaviors among veterinary students at a private College of Veterinary Medicine in the Southeast United States. Researchers collected data using a 54-item valid and reliable survey. Only students who did not already engage in daily stress management behaviors were included in the study. After recruitment and exclusion, a total of 140 students remained and participated in the study. Hierarchical multiple regression revealed that, for initiation of stress management behaviors, 49.5% of the variance was explained by depression, academic classification, and behavioral confidence. Regarding sustenance of stress management behaviors, 50.4% of the variance was explained by perceived stress, depression, academic classification, and emotional transformation. MTM serves as a promising framework for predicting initiation and sustenance of health behavior change. Based on the results of this study, interventions aimed to promote stress management behaviors in veterinary students should focus on the MTM constructs of behavioral confidence and emotional transformation.

ObjectivesA challenge to competency‐based medical education is the verification of skill acquisition. Digital badges represent an innovative instruction strategy involving the credentialing of competencies to provide evidence for achievement. Despite increasing interest in digital badges, there has been no synthesis of the health care education literature regarding this credentialing strategy. The present authors proposed to address this gap by conducting the first systematic review of digital badges in health care education, to reveal pedagogical and research limitations, and to provide an evidence‐based foundation for the design and implementation of digital badges.MethodsA systematic search of the medical education literature from January 2008 to March 2019 was conducted using MEDLINE, Web of Science, CAB Abstracts and ScienceDirect. Included studies described digital badges in academic or professional medical education programmes in any health care profession. Included studies were appraised and quality assessment, methodological scoring, quantitative analysis and thematic extraction were conducted.ResultsA total of 1050 relevant records were screened for inclusion; 201 full text articles were then assessed for eligibility, which resulted in the identification of 30 independent papers for analysis. All records had been published since 2013; 77% were journal articles, and 83% involved academic health care education programmes. Scores for quality were relatively moderate. Thematic analyses revealed implications for the design and implementation of digital badges: learner characteristics may moderate student outcomes; the novelty effect can negate the value of digital badges, and educators may overcome instruction‐related challenges with digital badges using design and implementation strategies such as the creation of badging ecosystems.ConclusionsThe results indicate a growing momentum for the use of digital badges as an innovative instruction and credentialing strategy within higher education and provide evidence for outcomes within a learner‐centred, competency‐based model of medical education. There is a paucity of research to support the design and implementation of this credentialing system in health care education. The potential benefits necessitate future high‐quality analyses reporting institutional, patient and workplace‐based outcomes to evaluate the effectiveness and moderating conditions of digital badges.

Evaluation of veterinary students' surgical skills by using digital recordings with a validated rubric improves flexibility when designing accurate assessments.

Simulation in veterinary education offers a solution for bridging the gap between observation and performance of clinical skills. An equine neck model was created that allows repetitive practice of jugular phlebotomy, intramuscular (IM) injection, and intravenous catheterization. The aim of this study was to validate the model for jugular phlebotomy and IM injection. We surveyed experienced veterinarians on the model's realism and the comprehensiveness of its features. In a randomized experimental study, we compared the learning outcomes of first-year veterinary students trained on the model (n=48) and students trained on equine head-neck cadavers (n=45). There was no difference in post-training performance of phlebotomy on the live horse between cadaver-trained students and model-trained students when assessed by a checklist (cadaver 6.87±0.33; model 6.89±0.77; p=.99) or a global rating scale (cadaver 5.23±0.87; model 5.32±0.77; p=.78). No difference was found between post-training scores for IM injection when assessed by checklist (cadaver 6.87±0.34; model 6.89±0.31; p=.76) or global rating scale (cadaver 5.23±0.87; model 5.32±0.77; p=.75). Veterinarians (n=7) found this low-fidelity model acceptable and supported its use as a training tool for veterinary students. Students reported in a post-lab survey that they felt models were as helpful as cadavers for learning the procedures. These results support the use of the model as a component of first-year veterinary student curriculum.