The project continues...

This fall term meant the continuation of my research project. I'm excited and cant wait until its completed! I had ran into a few issues at the end of last term, one of which involved the State of California. Originally my project was to cover family physicians and small animal veterinarians in four states, Texas, Florida, New York, and California. My reasoning was since I am covering a subject matter center around zoonotic diseases, the combination of these states would cover pretty much all of the zoonotic diseases that would be prevalent in the United States.

Zoonotic diseases vary from area to area due to many circumstances including climate, population density (I.e. diseases carried by white tail deer are not typically found in heavily populated cities), native species of wildlife, the level of agriculture in a given area, and the financial stability of an area (I.e. people financially stable travel more frequently, including out the country, exposing them to zoonotic disease). I called the licensing board for the State of California to inquire about having a contact list of small animal veterinarians. I was told I needed to fax a letter with my intent and their legal department would determine if they could release the information to me. I did so really expecting to hear they would release the information to me, since I was only asking for contact information, the same information a pet owner could acquire when looking for veterinary assistance. I was told they could not release that information to me....so, I no longer included California in my study.

Since the spring I also added a subtopic of what other countries, such as the UK, are doing...are they encouraging communication between both medical profession and if so, how? I would like to be able to compare and contrast where our medical think we are at to what another country, similar to our own, is at.

If you've been following to see how things are going, stay tuned...over the next couple of weeks there will be more to say....

Unexpected complication

Well, I ran into an issue that I really wasnt expecting...I contacted the veterinary medical board in State of California to find out if I could acquire a list of small animal veterinarians. Although I can find a listing of veterinarians on the governments website, I can not single out those that strictly work with small animal. Most veterinarians are small animal veterinarians, however it would save time if I could find a list of those that simply practice as small animal veterinarians.

How would that help me?

The focus of my capstone project is small animal veterinarians and family physicians; a list already determining all of the licensed small animal veterinarians in a state would reduce my additional steps of looking up every potential contributor to my capstone online to determine their primary patient species. Its not impossible, just incredibly tedious.

To get back to California...

When I spoke to the office of the veterinary medical board I came to one of my first official stand stills, they wanted me to fax them the jest of my capstone study. I immediately sent out the following statement...

In the United States, four of every 10 homes own a dog and three of every 10 homes own a cat1. Zoonotic disease accounts for approximately 60% of all infectious pathogens2. A collaborated effort between veterinary medicine and human medicine is required to reduce or eliminate zoonotic disease transmission. The purpose of the study “Friend or Foe? The working relationship between veterinary medicine and human medicine” is to evaluate current communication methods regarding reportable zoonotic diseases between members of both health professions and develop the means to create improved communication. During my video presentation, I will conclude with recommendations to improve communication between small animal veterinarians and family physicians.

Florida, California, Texas, and New York are the states in my study and are the best representation of the continental United States due to their climates, ecological factors, and economic standings all of which can influence the types of zoonotic diseases seen in each area3. Each states sample is determined by the states provided current licensed and practicing family physicians and small animal veterinarians. I am sending a request to complete my survey provided by a link through www.surveymonkey.com to a random 150 professionals from each profession in each state, ultimately requesting voluntary participation from 600 small animal veterinarians and 600 family practice physicians. In addition to the request for completing a survey, I am asking for participation in phone interviews and a web forum. The electronic survey will collect general information on the communication efforts between veterinarians and family practice physicians. However, the phone interview will provides specific viewpoints from the professional and a web forum will be offer a means for professionals to give a viewpoint in real time in an environment similar to that of brainstorming. Analyzed data provided by the electronic survey is anonymous, the phone interview may or may not be anonymous, and the web forum will not be anonymous. The consent form indicates the anonymity of the phone survey, denotes the lack of anonymity with the phone interview and web forum, and explains that declining involvement in the interview or forum does not affect the results or potential participation in either.

Approximately a week and a half later I received an email from the State of California that their legal department does not believe its a good idea to release the information to me. To be honest it did shock me. I'm not asking for information I do not already have access to through their website. The point of contacting them was to shorten my steps so that I do not have to look up every potential participant for my project. Prior to contacting the veterinary medical board in California, I had also contact the veterinary medical boards in Florida, New York, and Texas and had no problem getting information from them (when information was available, as some states do not make a distinction on the primary patient species).

So, what was the result?

I decided to not acquire information from veterinarians in the State of California. I really do not understand what the problem is, however at this point since I received correspondence in writing telling me they would not release the information to me, I do not want to cause a potential professional rift. If I was completing this survey as a professional having already attained my degree, I may have a difference of opinion on the matter.

Why was this unexpected?

Since the veterinary medical boards in most states provide the contact information for their licensed and practicing veterinarians I did not see it as a problem to contact them and ask them to narrow down their pre-established public list. Its one of those bureaucratic red tape situations that requires me to evaluate the scenario determining if the possibility of causing ripples in the pond is necessary (or should I take my business elsewhere...lol).

1 Crosby, Janet. (2009) Veterinary Medicine. Retrieved on December 8, 2009. Retrieved from
http://vetmedicine.about.com/diseasesall/a/aa051303a.htm
2 Rabinowitz, Peter M, Conti, Lisa A. (2010) Human-Animal Medicine Clinical Approach to Zoonoses, Toxicants and Other Shared Health Risks. Saunders.

3 Department for International Development. (2006) Zoonotic Diseases in Livestock. Retrieved on December 6, 2009. Retrieved from http://www.smallstock.info/info/health/zoonoses.htm

I propose...

I handed in a revised proposal this week and it was accepted (whew!). The first time I completed the proposal for this class I felt a little lost. Although the textbooks provided valuable information, it really wasn't practical for actually writing the proposal. After doing days and days of research before I did the paper, just to determine the format... voila, its complete! I would upload it for you, but I can't seem to figure out how to upload a .doc document (it appears blogger only allows for video's and photo's), so I decided to copy and paste it. However, your not seeing the entire 19 page proposal, just the literature review portion.

I hope you enjoy!

LITERATURE REVIEW

Zoonotic diseases account for 60% of all human pathogenic disease causing organisms (Rabinowitz, Conti, 2010). In the United States, four in every 10 homes owns a dog and three in every 10 homes owns a cat (Crosby, 2009). Pets bring people, more specifically pet owners, into situations where they can contract a zoonotic disease. What roles do the veterinary medical profession and human medical profession have or promote jointly in controlling zoonotic disease in their communities? The provided literature is going to explain why the need is present to define roles of health professionals, give present day examples when communication has been especially important, and define collaboration.

We are at an unprecedented time. Pet ownership is high, traveling to other countries is common, and in addition we are at war; the combination is an open door to zoonotic diseases Americans may not otherwise had been exposed to or heard of. With the high profile coverage of swine flu, or H1N1, the realization became clear of the importance of proper education through medical channels to prevent transmission.

In response to zoonotic diseases, such as H1N1, the Center for Disease Control and Prevention (CDC) combined efforts of The National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED) and the National Center for Preparedness, Detection, and Control of Infectious Disease (NCPDCID) forming the National Center for Emerging Zoonotic Infectious Disease (NCEVID; National Center for Emerging and Infectious Zoonotic Disease, 2010). Of the multiple ways the NCEZID helps to control zoonotic disease transmission in the United States, two are making an important contribution to this research project through their surveillance of outbreaks and disease and through their reporting of disease and outbreaks to the community and medical professionals (National Center for Emerging and Zoonotic Infectious Diseases, 2010). The NCEZID uses the publication Emerging Infectious Disease as a medium for medical professionals offering the latest information on infectious disease concerns.

A rabies outbreak in coyote populations of suburban Massachusetts is an example of a zoonotic disease requiring veterinary and human health professionals to relay risks and prevention measures to the general public (Wang, Brown, Smole, Werner, Han, Farris, DeMaria, February 2010). Organizations such as the World Medical Association (WMA) provides additional means for health professionals to acquire information in the prevention and control of disease transmission, their function is to “constitute a free, open forum for frank discussion, not of clinical problems, but of matters related to medical ethics, medical education, socio-medical affairs and medical topics generally (World Medical Association Inc, 2009).” The WMA emphasizes the shared roles both veterinary professionals and human health professionals have in controlling communicable diseases, “By their very nature, the fields of human medicine and veterinary medicine are complementary and synergistic in confronting, controlling and preventing zoonotic diseases from infecting across species (World Medical Association Inc, 2005).” To prevent the spread of a communicable disease there must be collaboration between both health professions.

Many subtopics exist among professions from issues of immune system suppression, when to vaccinate (in reference to human vaccinations), and the variations of medical treatment depending on location and resources (rural areas versus cities and well-populated suburban areas). Each subtopic explores another need for regular communication between veterinary professionals and human health professionals.

Sitaram Aryal (2000/2001) issues the point of antibiotic resistance as an important topic for both veterinarians and physicians “The wide spread use of antibiotics in human and animal has raised the concern about the development of resistant and multi resistant bacteria that posses a potential danger to animal and men, as resistance may cause treatment failure.” The American Society of Health-System Pharmacists (2009) offers resources to lay persons regarding the importance of vaccinating against the rabies virus. This is a wonderful resource. However if those in the veterinary or human health profession are not informing the general public of rabies control measures, for example, how will the general public become acquainted with the resource? How will those needing information on disease transmission attributed to contaminated water or soil know to seek out the resources of The Board of Agriculture and Natural Resources (1999)?

“Collaboration and communication between human medicine and veterinary medicine have been limited in recent decades, yet the challenges of the 21st Century demand these two professions work together (World Medical Association, 2005).” Diseases such as H1N1, rabies, Monkeypox, and SARS have brought to the forefront the need for communication on all levels between medical professionals (Lynn, Marano, Treadwell, Bokma, 2006). Animals, people’s pets, furry children, and four legged friends and their relationship to people have created a concern for disease, health professionals need to be the medium offering methods to control zoonotic disease transmission. From the man who coined the term zoonosis, nineteenth century physician Dr. Rudolph Virchow to the modern day 1996 Nobel Peace Prize winners Dr. Rolf Zinkernagel (physician) and Dr. Peter C. Doherty (veterinarian), disease transmission risks between humans and animals have required communication (Rabinowitz, Conti, 2010).

Under the Patient Bill of Rights, “The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information concerning diagnosis, treatment and prognosis (Purtilo, Haddad, 1996).” From the Patient Bill of Rights to the veterinary oath of swearing to use “scientific knowledge and skills” to benefit the general public through the “…promotion of public health, and the advancement of medical knowledge (American Veterinary Medical Association, 2004)” the convergence of both health professions are necessary to move towards eventual eradication, and present day control, of zoonotic diseases. Each profession offers something the other cannot; one has expertise in veterinary medicine the other in human medicine. The health of one household affects the health of its surrounding community and requires effective communication between pet owner, physician, and veterinarian.

REFERENCES

American Society of Health-System Pharmacists. (2009) Rabies Vaccine. http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=meds&log$=drug_bottom_one&part=a607023

Aryal, Sitaram. (n.d) Antibiotic Resistance: A Concern to Veterinary and Human Medicine. http://www.narc.org.np/publicaton/pdf/journal
/Vol4/antibiotic_resistance_concern_veterinary_human_me.pdf

The Board on Agriculture and Natural Resources. http://dels.nas.edu/banr/
Center for Disease Control and Prevention. National Center of Zoonotic, Vector-Borne and Enteric Disease. http://www.cdc.gov.ncved/

David J, Rutal, William A. (2001) Risks and Prevention of Nosocomial Transmission of Rare Zoonotic Diseases. Healthcare Epidemiology 2001:32

Lynn, Tracey, Marano, Nina, Treadwell, Tracee, Bokma, Bob. (2006) Linking Human and Animal Health Surveillance for Emerging Diseases in the United States. Impact of Emerging Zoonotic Diseases on Animal Health 8th Biennial Conference of the Society for Tropical Veterinary Medicine Volume 1081. Blackwell Publishing.

Medline Plus. Animal Bites. http://www.nlm.nih.gov/medlineplus/animalbites.html

Medline Plus. Rural Health Concerns.
http://www.nlm.nih.gov/medlineplus/ruralhealthconcerns.html

Morgan, Juliette, Bornstein, Shari L, Karpati, Adam M, Bruce, Michael, Bolin, Carole A, Austin, Constance C, Woods, Christopher W, Lingappa, Jairam, Langkop, Carl, Davis, Belinda, Graham, Donald R, Proctor, Mary, Ashford, David A, Bajani, Mary, Bragg, Sandra L, Shutt, Kathleen, Perkins, Bradley A, Tappero, Jordan W. (2002) Outbreak of Leptospirosis among Triathlon Participants and Community Residents in Springfield, Illinois, 1998. CID 2002: 34.

Purtilo, Ruth, Haddad, Amy. (1996) Health Professional and Patient Interaction. W.B Saunders Company.

Olsen, Christopher W, Grant, Sara. (n.d.) Preventing Zoonotic Disease in
Immunocompromised Persons: The Role of Physicians and Veterinarians.
http://www.cdc.gov/ncidod/eid/vol5no1/grant.htm

Olson, Debra, Hoeppner, Mary, Larson, Susan, Ehrenberg, Anne, Leitheiser, Agnes T. (2008) Lifelong Learning for Public Health Practice Education: A Model Curriculum for Bioterrorism and Emergency Readiness. Practice Health Reports. 2008: 123

Rabinowitz, Peter, Conti, Lisa A. (2010) Human-Animal Medicine Clinical Approaches to Zoonoses, Toxicants and Other Shared Health Risks. Saunders
Survey Monkey. (2010) http://www.surveymonkey.com

World Medical Association. (n.d.) World Medical Association Resolution on Collaborating between Human and Veterinary Medicine. http://www.wma.net/en/30publications/10policies/v2/index.html

One step at a time...

I know it has been a long time since I blogged about this project, but I can guarantee it’s not because there’s been a shortage of work… Since last blogging, I’ve accomplished the following:

• Signed up with Survey Monkey©. I created my surveys for both physicians and veterinarians.
• The consent forms have been completed (needing minor tweaking).
• The proposal was completed, however is in the process of complete renovation.
• I’ve narrowed down my sampling. The technique I was previously using has changed (I’ll explain more in a minute).
• I made a description of how I will be analyzing my data.
• I’ve purchased, and have been reading, a few books I think will give me additional information on zoonotic disease, communication between professionals, and communication between health professional and patient.

I have to admit, I cant recall ever working on a project this hard; not that I have never worked hard on a project, I have done data digging and informally researched projects on my own accord to simply discover more information on a particular subject matter. This has been a little intimidating at times.

Originally I was going to seek my sample from four states (Florida, Texas, California, and New York) and three population density locations (rural, suburb, and city) within each of those locations. I was attempting to get information from small animal veterinarians and family physicians that have the same clients (veterinarian)/patient (physician)…essentially looking for an ordered pair. How I was going to achieve this (in my mind anyway) was picking a location on the map as the epicenter for each of those three locations, use a compass measured out (according to the atlas’ key) 60 miles, figuring the average person would drive no greater than 60 miles on average to a physician or veterinarian. However, what I failed to think of was what the average person would drive if they live in a city or suburb, compared to what the average person would drive in a rural location. I live in a rural area in Michigan currently, however I previously lived in a suburb of Detroit (Waterford). Its nothing for someone to drive greater than 40 miles to a physician from the area I live now, however in Waterford the average person lived less than 20 minutes from their physician or veterinarian…this put holes through sampling techniques. Therefore, I’ve revised it to the following…

I still feel it necessary to choose Florida, California, Texas, and New York as my sample states (these states best represent the continental United States and the zoonotic diseases they may encounter), however instead of choosing three population densities, I’m looking at sending requests to 150 potential recipients (300 total, 150 for each health profession). I’m accounting for the population densities by asking each participant to provide the population size at the location of their facility; when I gave it greater thought, if I was to choose my location by population density I am making that a focus or variable of my study, and that is not my intent. However, I do believe it’s necessary to notes differences according to population.

To gather my sample, I looked up the state websites for each of the veterinary licensing boards and physician licensing boards. My plan is to create a database of email addresses for 1200 professionals (150 for each professional, 300 for each state); each name will be chosen at random, choosing every fifth or tenth name on the list of alphabetical professionals. I have run into a problem that will cost me more work with some states…some do not differentiate on their list of the specialty the veterinarian practices (such as small animal). This past week I called the licensing board for each profession at each state. In addition to finding out which professionals are small animal veterinarians, I also was double checking the accuracy of the information provided on their websites (I.e. how current); the endeavor consisted of two days of calling and also faxing the veterinary licensing board in California (so they could verify my intentions and find out through their licensing board and determine if their legal department would allow me to gain additional information from them). Granted the resubmission of my proposal is accepted, I’ll started data collecting on Monday, March 1st.

The survey portion of data collecting will run from March 1st until March 14th. The week of March 15th, I’ll be conducting phone interviews based on the information I collected from the surveys. In addition, a focus group (what I previously referred to as a web conference) will commence during the week of March 22nd. I look forward to getting through the data collection step and begin analyzing the data.

I purchased a few books, as I mentioned above, that I believe will provide additional information and support for my research. The books I purchased include:

• Impact of Emerging Zoonotic Diseases on Animal Health, 8th Biennial Conference of the Society for tropical veterinary medicine (2006). Although you may be reading this and thinking “doesn’t that say for tropical veterinary medicine,” trust me, there is very relevant information in this book; an example include “Linking Human and Animal Health Surveillance for Emerging Diseases in the United States (Lynn, Marano, Treadwell, Bokma, 2006).”
• Human-Animal Medicine Clinical Approaches to Zoonoses, Toxicants and Other Shared Health Risks (Rabinowitz, Conti, 2010). This is a wonderful book I would recommend to any veterinary or health professional that comes into contact with any kind of zoonotic diseases either through patients/clients or themselves. The information covered in this text is proving to be invaluable to my research project, but it also is going to be invaluable as a Licensed Veterinary Technician.
• Health Professional and Patient Interaction (Purtilo, Haddad, 1996). The purchase of this book was to gain a better understanding of patient and human health professional relationship.

Amidst the reading, researching, and revising I’ve been quite busy (sleep has been a little deprived at times), no complaints here however. This has been a wonderful experience and I know its going to affect (positively) my career choices. In addition to the hope that I will be able to publish this study when it’s complete, I’ll know the process for future opportunities.

Location, location, location!

Today I called the two websites I mentioned in my last post (Vyew and Webex by Cisco). After reviewing each site I was rather confused to what exactly I needed to host a web forum. Neither site did a good job in explaining their services and when those services would be useful. And to be honest, there was little clarification given when I called as well.

I first called the phone number on the website for Vyew (800-594-4559)...I called and no one was home. You can not speak to a person. A voice says you've reached the number for Vyew, however you have to leave a number. I decided not to do this because the recording didn't say what department I have. I may be calling the wrong department...it felt like a waste of time. So I moved on...

I spoke to Shawn at Webex (888-469-3239), he was friendly but I knew just as much before I spoke to him then I did after. I explained to him that I needed a web meeting room to conduct a forum for a course project. He asked how many people and I estimated at 10 to 15 (I'll explain more below). He said there was a free trial period (which I had seen on the website) otherwise the price would be $49.99/mo (which is also on the website). I said I had noticed a lot of other options, does it look like I would need anything else besides the email, he said he didn't think so. I then asked exactly how does this work (this part was not on the website)...he explained an email would be sent with the web rooms link to the participants explaining the date and time of the forum. I asked if it was possible to have the service for one month and he said I could do that.

After calling I really felt like I didn't know enough to decide where to turn or more specifically which sites I should turn to seeking a web conference or forum room. However I found a site on line that gives an independent opinion of various sites that offer web conference rooms (http://www.webconferencing-test.com/en/webconference_home.html). After reviewing this site I plan on taking the weekend to look at the top five sites and call them on Monday. My goal is to have a decision by the end of next week.

This web forum idea came out of the thought to draw the most honest and open opinion of where medicine professionals believe our current relationship is, how to best improve the relationship, and what the impact has on controlling zoonotic disease. A web conference room would be pooling medicinal professionals both by their location and later a conference with those speaking most on the subject with professionals from other areas. I realize this is a big endeavor and I have only a few months to complete it. So I would like to have the first forum in the beginning of March and the last by the end of March or very beginning of April.

Essentially this entry is boiled down to this....I've done some research and decided I need to do more (forget making a long story short, huh). Hopefully when you read my entries from next week you'll see I've made a decision.

~Meresa

Week Two...More ideas to come...

This week I've started laying the foundation for my research project. I'm quite excited specifically about one of the ideas I have...I want to have a forum on the web and in attendance will be veterinarians, physicians and hopefully health department staff discussing their roles in zoonotic disease prevention; my role will be mediator. I believe this will the center of my data collecting and many avenues will branch off of it. I've look at a few sites so far that may be able to accommodate my projects web forum needs:

• Vyew Instant Workplaces (http://vyew.com/site/): Vyew caught my attention mainly because of the awesome review they received from PC world. They not only offer a means to have the forum, but the information can be kept through their server to be later reviewed. Many formats can be used for conducting the forum such as web cam and voice over IP, however the format I'm interested in is text messaging. I like the idea of being able to keep a formal record of who attended and of what was said. I have to admit their pricing is a little confusing and I'm not exactly sure what I would need and how much it will cost. To get a basic room is free however there's a limit in participants and advertising by the website will be shown during the meeting. I'll be calling their customer service this upcoming week (week of January 25th) to see what their staff recommend.
• Cisco Webex (http://www.webex.com/lpintl/us/sem/online_meetings.htm?CMP=KNC-sem&TrackID=1016574&hbxref=http%3A%2F%2Fwww.google.com%2Fsearch%3Fsourceid%3Dnavclient%26ie%3DUTF-8%26rlz%3D1T4ACGW_en___US347%26q%3DForum%2Bor%2Bmeeting%2Brooms%2Bonline&semid=G14.017.001.online%20meeting&goid=WebexUS_1016574): Cisco is a rather well known company in business services, so that makes me look at what they have to offer very seriously. I don't know a lot about what they are offering, because they don't have as good website as Vyew in explaining their services. Other than the 14 day free trial period they advertise on their website, I'll have to call their customer services representatives to acquire more information.

The forum is a good way to get realtime information from professionals. A survey is a great means, however I do not believe it will get the most honest responses. To have a "room" of professionals sharing the roles, where they believe improvement needs to be made, and a way to document all (so their isn't any confusion of who said what...its formal documentation), will give the clearest, direct, and open information.

This upcoming week I plan on narrowing down the cities to target in my research. The states I'm using were decided on quite awhile ago and include: Texas, California, New York, and Florida. Each of these states offer zoonotic diseases that are unique or more prevalent to them because of their climate, unique ecological challenges, or simply due to the melting pot of communities inside their borders. In addition these four states pretty much make up a good representation of the issues in the rest of the country. The only exception is Hawaii. However there isn't any other state in the United States that has a climate like Hawaii making a focus of that state a poor choice.

The focus in my capstone class this upcoming week is a literature review. This last week the focus was writing the outline for the literature review. To be honest, I do not believe I completed the assignment well and I stumbled across a problem I've had for as long as I can remember. If I think its an extra step (such as creating the outline for upcoming assignment) I have a difficult time doing it. If I can sit down and simply write the paper for example, and the outline isn't necessary I have a difficult time making the outline or what I think of as simplifying the work. This may sound strange but I've noticed this issue with myself in the past. However I was able to review the list I compiled last term for my sources, and they still seem to stand up well; I plan on uploading a copy of the proposal I did for last term so you can see the sources I've chosen.

I'm always keeping my eyes open for more material in the news regarding zoonotic disease and prevention, looking for additional potential sources. In my local newspaper (Ludington Daily News) there was an article from a syndicated columnist (Dr. Gott) titled "Dogs may be culprit in the case of owner's rash (Dr Gott, January 2010)." The woman (a pet owner) that wrote Dr. Gott simply tells of a seeping rash she gets every so often on her arms and ankles that has left her dermatologist stumped as to its cause. Dr. Gott points out about her dogs and the location of the rash that point to the possible of the cause agent being related to her pets. While reading this article it reiterated the lack of information asked by professionals regarding if someone has pets or not and the role their pet may have in transmitting disease or other health conditions to their pet owners. I'm all the more excited about the potential my paper holds.

~Meresa

Dr. Gott (January 23, 2010) "Dogs may be culprit in the case of owner's rash." Ludington Daily News. Shoreline Media Inc.

Introductions

I've started this blog for the main purpose of tracking my progress in completing my capstone project. Currently a full time student at St. Petersburg College, I'm pursing a bachelors in applied science, major in veterinary technology. To complete the program I must complete a capstone project of my choosing. Last term after making a list of various possibilities from evaluating current methods of reducing aggression in pets making their yearly visit to the veterinarian to developing a deworming and vaccination program for cattle in Niger (West Africa), I decided on a project that not only has the potential to benefit the veterinary profession here and now, but will also help to create a solid foundation for my career choice...a veterinarian working internationally in sustainable agriculture.

Before being in the Peace Corp my goal was to become a Veterinarian (never changed) and specialize in wildlife and exotics. My more than ten years as a Licensed Wildlife Rehabilitator (Michigan) and having worked with wildlife and exotics in the veterinary setting instilled a passion to contribute to the preservation of native species. The passion is still there however its not as strong as what was provoked during my brief stay in Niger.

Nothing makes something more real such as poverty, until you see it personally. My experience in Niger was sobering. I live in a wonderful country, the United States of America, where even when times are at their worse, I can turn to my government or local organizations. The people in Niger, a country that was labeled as the poorest country in the world by the United Nations in 2007, do not have anyone to turn to but the visiting non-governmental organizations (NGO's). I want to clarify this is not because their government doesn't care about them, the government has little resources to generate a decent means of supporting their people when more than 70% of the country is desert. Its great when NGO's enter into a country and offer aid in some fashion (example. clothing, food, etc.). However Niger is an example of how providing sustainable assistance (example. seeds for crops, livestock, wells, etc) is a measure that would last well beyond the exodus of an NGO. In our country we would also refer to the difference as being a hand out or a hand up.

My capstone project titled "Friend or foe? The working relationship between veterinary medicine and human medicine" is the start to working internationally in sustainable agriculture. You may be reading this and say "How is studying the working relationship between the two professions in the United States going to help you in working internationally?" The one thing I definitely walked away with...poverty will not be ended by one person, one group of people, one culture, and definitely not through the valiant efforts of one profession. We are going to all have to work together. However the leaders will be those in the medical profession (veterinarians and physicians) demonstrating and enabling methods for keeping livestock at their healthiest and crops at their fullest, leading to the annihilation of poverty.

What is the current working relationship between the veterinary and human medicine professions? How effective is the relationship in controlling zoonotic disease? And what measures are recommended (as a result of the collected data) between the two professions to enable both in zoonotic disease prevention?

As you follow my entries you'll see my capstone project materializing. Literature reviews, determining the methodology, submitting a project proposal, data collecting (examining the methods of data collecting), publishing the results, and determining potential zoonotic disease prevention methods are what you will be reading for the next 12 weeks. I hope you'll enjoy the adventure as much as I will!

Meresa Salisbury, LVT