Companion-animal hoarding is a significant problem in the United States and internationally. Hoarding situations can incubate for years before a case is reported to law enforcement or animal control agencies. According to a survey by Gary Patronek, animal control agencies have estimated there are approximately 3000 reportable cases of animal hoarding annually in the United States. Animal hoarding cases vary in size from fewer than 20 animals to hundreds of animals. Every case of animal hoarding results in suboptimal animal welfare. Wake County, North Carolina, developed a proactive plan for addressing companion-animal hoarding that implemented a team approach to assist animals at risk, hold people accountable, address the mental health component of this problem, and create a more humane community. The plan involved animal control officers, crisis intervention counselors, law enforcement officers, veterinarians, veterinary technicians, and animal rescue partners. This intervention strategy was implemented in 2015, and cases were tracked to document animal outcomes. The conclusion of this experience is that a diverse team approach can best address the animal and human welfare challenges and the environmental concerns associated with animal hoarding.

Background: Urbanization is occurring rapidly on a global scale and is altering mosquito communities, creating assemblages that are characteristically less diverse. Despite high rates of urbanization and ample examples of vector-borne diseases transmitted by multiple species, the effects of urbanization-driven mosquito diversity losses on disease transmission has not been well explored. We investigated this question using the dog heartworm, a filarial parasite vectored by numerous mosquito species. Methods: We trapped host-seeking mosquitoes in undeveloped areas and neighborhoods of different ages in Wake County, North Carolina, USA, analyzing captured mosquitoes for heartworm DNA. We compared within-mosquito heartworm infection across land-use types by Kruskal-Wallis and likelihood ratio tests. Using zip code level data acquired from dogs in a local shelter, we performed linear regressions of within-host heartworm prevalence by within-mosquito heartworm prevalence as well as by three mosquito diversity measures. We also determined the best predictor of host-level prevalence among models including within-mosquito infection, mosquito diversity and abundance, and socioeconomic status as variables. Results: Suburban areas had lower within-mosquito heartworm prevalence and lower likelihood of heartwormpositive mosquitoes than did undeveloped field sites, although no differences were seen between suburban and undeveloped wooded sites. No relationships were noted between within-mosquito and within-host heartworm prevalence. However, mosquito diversity metrics were positively correlated with host heartworm prevalence. Model selection revealed within-host prevalence was best predicted by a positive relationship with mosquito Shannon-Wiener diversity and a negative relationship with household income. Conclusions: Our results demonstrate that decreases in mosquito diversity due to urbanization alter vector-borne disease risk. With regard to dog heartworm disease, this loss of mosquito diversity is associated with decreased heartworm prevalence within both the vector and the host. Although the response is likely different for diseases transmitted by one or few species, mosquito diversity losses leading to decreased transmission could be generalizable to other pathogens with multiple vectors. This study contributes to better understanding of the effects of urbanization and the role of vector diversity in multi-vectored pathosystems.

Nurses need to be prepared to respond to mass casualty incidents. Simulation is an ideal teaching intervention that can be used to prepare nursing students to effectively triage patients and allocate limited resources. This article describes a detailed interprofessional mass casualty simulation of a bus crash with 32 victims. Nursing students trained with emergency responders with students acting as charge nurses throughout the simulation. The details of the simulation are provided for faculty to replicate.