Scientists at the Royal Veterinary College, contributing to a programme to tackle some of the most harmful and widespread endemic diseases that commonly affect farmed animals in the UK, have developed a severity estimation calculator for post-weaning multi-systemic wasting syndrome (PMWS).
Post-weaning multi-systemic wasting syndrome (PMWS) is a common disease of young pigs in the U.K. It is extremely debilitating, causes considerable suffering and poor welfare, and has a high mortality of up to 30%. It is estimated that the disease costs the UK farming industry £30m per year.
The £2.4m project - headed by Professor Dirk Werling from the Royal Veterinary College and funded by the Biotechnology and Biological Sciences Research Council (BBSRC) through its "Combating Endemic Diseases For Farm-Animal Sustainability" programme (CEDFAS), the British Pig Executive (BPEX), and two industrial partners, Pfizer Ltd (UK) and BioBest - aims to identify why PMWS occurs and to develop new methods of controlling the disease.
One key-component of the project is the direct involvement of British pig farmers, thereby guaranteeing that pigs in Britain will be the first to benefit from this research, while collaboration with a major international pharmaceutical company will ensure that new veterinary products will be made available to pig farmers worldwide.
Now, two members of the team, Dr. Barbara Wieland and Pablo Alarcon-Lopez, a second year PhD student, have developed a novel approach to quantify severity of PMWS based on morbidity and mortality data and presence of porcine circovirus type 2 (PCV2). They applied factorial analyses, using data collected from 147 pig farms in England to identify variables contributing to variation in PMWS severity in a biologically meaningful way.
Together with other known variables linked to PMWS, the resulting factors were used to derive an algorithm for PMWS severity. The derived algorithm was used to develop a PMWS severity calculator, which now can be used by farmers directly to assess the PMWS severity on their own farm (http://www.bpex.org.uk/articles/300874).
The levels of PMWS severities identified on farm level can now be used to identify risk factors related to the different severity-categories, to assess the efficacy of PCV2 vaccination and to investigate the economic impact of potential control measures on a farm.
Voting in this year's RCVS and VN Councils elections has now opened, with veterinary surgeons and veterinary nurses able to cast their votes online, by post or by text message.
All candidate details and ballot papers have been posted earlier this week so should be landing on doormats imminently.
As in previous years, there is an opportunity for voters to quiz the candidates on VetSurgeon.org and VetNurse.co.uk. Questions submitted before 24th March will be entered into a draw to win one of three 6-bottle mixed cases of wine. Thereafter, there will be an open forum on both sites.
As in previous years, the College will make an optional 20p charitable donation to the Veterinary Benevolent Fund on behalf of each person who votes.
Lydia Brown, President of the VBF, said: "The Veterinary Benevolent Fund is very grateful for funds raised through the elections. We appreciate that life in practice can be stressful, and offer support in a variety of ways to veterinary surgeons and veterinary nurses."
RCVS Council comprises 40 members: four are appointed by the Privy Council, 12 by the veterinary schools and 24 by direct election.
Each member is appointed for a four-year term of office. Every year, six members of Council retire at the Annual General Meeting, though may seek re-election.
In 2011, ten candidates are standing for the six seats available, including six incumbent Council members. The candidates are:
RCVS VN Council comprises 17 members: eight elected veterinary nurses, six veterinary surgeon members (including three from RCVS Council), one Lantra representative and two lay members.
Two seats are usually available each year, with each member serving a four-year term.
This year an extra seat for a one-year term is available, due to a member retiring mid-term; this will be filled by the third-placed candidate.
There are four candidates for the three seats:
All votes must be received before 5pm on 27 April 2011 - a slightly earlier deadline than usual, which takes account of the extra public holiday for the Royal Wedding.
Any veterinary surgeon who has not received their ballot paper should contact Ian Holloway (020 7202 0727 i.holloway@rcvs.org.uk) for an official duplicate; veterinary nurses missing their ballot papers should contact Annette Amato (020 7202 0713 a.amato@rcvs.org.uk).
The BSAVA has announced a partnership with the University of Liverpool to develop a national UK disease surveillance network for companion animals.
Originally established in 2008, the Small Animal Veterinary Surveillance Network, SAVSNET, aimed to monitor the disease status of the UK small animal population (mainly dog, cat and rabbit). However, funding for the project came to an end in August 2011. At this point, BSAVA stepped in with support, as it believed that not only would the profession benefit from this source of information, but that it is in fact vital for the successful management of disease in small animals.
BSAVA President Andrew Ash said: "SAVSNET ticks all the boxes for BSAVA. High quality large scale epidemiological research helps us fulfil our obligations as a charity to public good, the information on disease surveillance gives us the information to treat animals better, and the research papers help us inform veterinary policy and education. This is an important scheme for both animal and human health."
Participation by diagnostic labs and practices is voluntary, and all data gained will be made anonymous before being reported. For more information, email savsnet@liverpool.ac.uk.
A team of top equine vets is aiming to raise £125,000 for the Society for the Protection of Animals Abroad (SPANA) by travelling 3000 miles through Europe by motorbike between 22nd August and 9th September.
Sponsored by Elanco Animal Health, the seven-strong team is planning to travel through Belgium, the Netherlands, Germany, Switzerland, France, Italy, Morocco and Spain and deliver lectures to eight European and African veterinary schools in just two weeks.
Led by Professor Derek Knottenbelt from the University of Liverpool, the team also includes Professor Josh Slater from Royal Veterinary College, Dr John Burford from the University of Nottingham, Dr Caroline Hahn from the University of Edinburgh, Dr Michael Hewetson from the University of Helsinki, Ms Joanne Suthers from the University of Liverpool and Dr Edmund Hainisch from the University of Vienna. They are being supported by Jeremy Hulme, chief executive of SPANA, Nic Van Gelder, fundraising and supporter care administrator at SPANA and Cerian Stephens.
All money raised will provide SPANA with diagnostic and surgical equipment for the charity's veterinary clinics for working animals in Mali and Mauritania and for the further development of the Bamako Disabled Riding Centre in Mali.
Mike Brown, Elanco's UK and Ireland country director said: "We are delighted to be sponsoring the Vets with Horsepower European Tour which will raise vital funds for working animals in some of the world's poorest countries. This is just one of the many worthwhile initiatives we are supporting in 2012 which focus on alleviating world hunger, spearheading agricultural leadership, enhancing the human-animal bond and caring for the environment."
For further information on the Vets with Horsepower European Tour visit www.spana.org/horsepower.
Blue Cross has announced the results from its National Equine Health Survey (NEHS) which show that lameness is three times more likely to be caused by conditions such as osteoarthritis in the limb rather than problems in the foot.
Blue Cross runs NEHS in May each year, in partnership with the British Equine Veterinary Association (BEVA). It is sponsored by SPILLERS and Zoetis and supported by the UK’s leading equestrian organisations and charities. This year saw a 35% increase in participation compared to 2014, with survey records returned for almost 15,000 horses, ponies, donkeys and mules.
The charity says that whilst of course the horse’s foot is fundamental to soundness and performance, NEHS results have shown consistently that limb lameness, as opposed to foot lameness, is in fact the biggest syndrome affecting horses.
In the latest survey, conducted in May, a total of 18% were recorded as lame. 13.5% of these were recorded as suffering with lameness such as osteoarthritis, also known as degenerative joint disease (13.9% in 2014 and 14.8% in 2013).
Meanwhile foot lameness was recorded in 4.5% of returns, a similar figure to previous years.
Josh Slater from the Royal Veterinary College, who is member of BEVA’s Health & Medicines Committee and analysed the NEHS data, said: “NEHS is now producing important evidence that is replacing subjective opinion. While the lameness figures were initially surprising, given that the foot has been generally regarded as the main problem area, the fact that these figures have remained consistent over the past three years gives constructive credibility to the data. Our findings will help owner vigilance with day-to-day healthcare as well as help prioritise on areas for future veterinary education and research.”
The six most notable disease syndromes identified in the 2015 National Equine Health Survey were:
23.2% of horses were reported as being overweight with a Body Condition Score of 3.5-5, continuing the upward trend seen in previous years (16.9% in 2014 and 7.8% in 2013). Next year’s survey will explore links between obesity and the possible associated rise of obesity-related diseases such as equine metabolic syndrome (which was reported in 2.4% of 2015 returns) and laminitis.
The survey also enables participants to report on any health problems not covered in the survey questions, giving them a chance to shape future survey subjects.
Gemma Taylor, Education Officer at Blue Cross explains: “This year 11% of our free text answers mentioned gastric ulcers giving a valuable insight into the prevalence gastric ulcer syndrome in the principally leisure horse NEHS population. As a result we will be adding new questions to the 2016 survey to help us find out more.”
The 2015 NEHS survey results are now available from http://www.bluecross.org.uk/nehs2015results. To register for next year’s survey, visit www.bluecross.org.uk/nehs
Petplan has launched PetPeople, billed as the largest circulation pet focussed customer magazine.
Hill's Pet Nutrition and Cat Professional are working in partnership to improve knowledge of feline lower urinary tract disease by giving complimentary copies of 'Caring for a cat with lower urinary tract disease' by UK feline specialists Dr Sarah Caney and Professor Danièlle Gunn-Moore to veterinary professionals and owners of cats affected by the condition.
Feline lower urinary tract disease is thought to affect up to 10% of cats, with particular prevalence in the indoor cat population and it is often a complex and distressing condition for cat owners to tackle.
Hill's has sponsored 1000 copies of 'Caring for a cat with lower urinary tract disease' , and is giving away vouchers which allow the recipient to visit the Cat Professional website (http://www.catprofessional.com/) to download an interactive copy of the book.
'Caring for a cat with lower urinary tract disease' is the third title in the successful 'Caring for a cat' series. Renowned cat behaviourist and bestselling author, Vicky Halls reviewed the book in glowing terms: "Feline lower urinary tract disease is a complicated subject for owners to fully appreciate so it is wonderful, at last, to have one book that contains all the necessary information that can be recommended to everyone"Hill's Pet Nutrition are distributing the complimentary vouchers to owners who contact their customer service freephone line for advice on the condition (0800 282438 - 9am - 4pm, Monday to Friday). Veterinary Professionals using the free Urolith Analysis Service offered by Hill's, or the Hill's Veterinary Technical Enquiry Line to gain help and advice on nutritional management of Feline Lower Urinary Tract diseases are also able to claim a complimentary voucher to redeem.
Adrian Pratt, Veterinary Affairs Manager for Hill's comments "FLUTD is a difficult disease to manage, let alone explain to fully to an owner. What Sarah and Danielle have done here is fantastic and will help owners better understand their cat's problem. That can only be good for the pet"
The 45-minute webinar: Debt Management: Prevention Is Better Than Cure is presented by Mike Brooks from veterinary-specialist debt recovery agency, dsl.
VPMA President Renay Rickard (pictured right) said: "Debt can affect any business, but, because of the role vets play as care-giver in an emotionally-based animal-owner relationship, we are particularly vulnerable. This is something that is commonly brought up by members at our regional meetings and events, and it’s a real dilemma for them how to juggle being strict with payment policies against owner expectations and misperceptions of the cost of veterinary medicine.
"This has been a very popular topic in both our regional meetings and with our webinar and we wanted to open it up to more people to help them tackle this topic in their practices. The feedback on this webinar has been very positive. Mike gives clear guidance on how to set up payment protocols that will minimise debt in such a way that maintains the client-practice relationship. There’s also information on how to recover existing debts. It makes sense to prioritise tackling this issue as if we’re not paid, then we can’t deliver the service that we are expected to, and that our patients need.
"We’re pleased to open this webinar up to all practices as a Christmas gift, and hope it will also highlight the support that is available through VPMA membership."
The webinar can be accessed through a link on the home page of the VPMA website www.vpma.co.uk.
Aimed at all members of the veterinary team across Europe, the webinar is moderated by veterinary nutrition expert Dottie Laflamme.
The webinar, which will also be available on demand after the event, follows others in the series that allow conversations about nutrition to be integrated into everyday consultations.
Speakers Shoshanah Verton Shaw, RVT, VTS (nutrition), and Marge Chandler (a diplomate of the American College of Veterinary Internal Medicine, the European College of Veterinary Internal Medicine and the American College of Veterinary Nutrition) will be sharing their tips for handling nutrition discussions in a non-confrontational way that preserves the client bond with the vet and the practice.
Registration for this and another three free webinars is available at https://bit.ly/purinawebinars2022.
Following stock challenges earlier in the year, the company is now urging vets to encourage farmers to vaccinate their flocks to prevent abortions during lambing.
Roy Geary, regional director for Northern Europe at Ceva Animal Health, said: “While we realise that the temporary delay of Cevac Chlamydia has been inconvenient to our valued sheep farmers we would like to thank all our customers for their patience and support during this challenging time.
"The vaccine supply is now available in the UK for the latter end of the season.
"Farmers tupping later in October should therefore be encouraged to vaccinate their flocks to protect their ewes from this devastating disease.”
www.enzooticabortion.co.uk
The Walpole Bay Tidal Pool is the biggest in the UK, covering four acres.
Everyone taking part is being challenged to raise at least £100 for Vetlife, to go towards its helpline, health support and financial support for the veterinary community.
Sea temperature at this time of year is a decidedly brisk 10 degrees Celsius, but Vetlife says the dress code is reasonably relaxed: anything from a swimming costume to a full diving dry suit!
https://events.more-human.co.uk/event/1713190086537x259173669533122560
To mark its 20th anniversary, Woodley Equipment Company is holding a prize draw to win one of three bottles of Chateau Pitray 1989 Bordeaux red wine.
Woodley Equipment Company Ltd was established in 1989 by Mike Wickham, a biomedical scientist who specialises in haematology and blood transfusion.
Visit www.woodley20years.com to enter the draw. The winner will be drawn on Friday 30th October 2009.
US veterinary equipment manufacturer Midmark is holding a draw for a Matrx VMS anaesthesia machine, open to all UK veterinary practices.
Click this link, enter your details, and the winner will be announced on 7th July 2010.
The BVA has welcomed an update report on dog breeding issues by the Associate Parliamentary Group for Animal Welfare (APGAW).
Working with a small group of stakeholders including the British Veterinary Association, Dogs Trust, Kennel Club and RSPCA, this report looks at what has been done since the first APGAW report in late 2009 and the airing of Pedigree Dogs Exposed (2008) and Pedigree Dogs Exposed: Three Years On (2012).
BVA Past President Harvey Locke said: "The BVA fully endorses the recommendations and practical solutions offered by this timely report."
Mr Locke drew attention to a number of points in the report's action plan including:
Mr Locke added: "I am pleased that the APGAW report recognises the vital role that education plays in tackling irresponsible dog ownership and would very much like to see the inclusion of animal welfare as part of the core curriculum.
"I am also delighted that the group recognises the value of a puppy contract. The BVA Animal Welfare Foundation and RSPCA have recently launched a puppy contract and puppy information pack (PIP) which arms buyers with the knowledge to give themselves the best chance of getting a fit, healthy and happy, well socialised pet to join their household. The contract and PIP have also been designed to help good breeders demonstrate the care and attention they have devoted to their puppies' breeding and upbringing.
"Much work has already been undertaken to improve dog breeding but there is much more to be done and the momentum must not be lost. I am most grateful to Neil Parish MP, chairman of APGAW, for his commitment to producing this report. It is an excellent means of keeping the issue high on the agenda by encouraging wider dialogue and debate within Parliament and in the EU."
The Animal Health Trust's (AHT) Dr Sue Dyson has been awarded a place in the International Equine Veterinarians Hall of Fame, in recognition of her contribution to hoof care in horses.
Sue, who is Head of Clinical Orthopaedics at the AHT, has lectured internationally and is known for both her clinical work with horses and an extensive research record, having published more than 200 refereed papers on lameness and diagnostic imaging in scientific journals. She has also co-authored several veterinary textbooks as well as training and competing as a high-level rider in international events.
Established in 1997, the International Equine Veterinarians Hall of Fame honours veterinary surgeons who have contributed to the knowledge and recognition of proper hoof care for horses. Vets are nominated either as practicing equine vets who work closely with farriers in the field, or as college and industry vets involved in teaching, research or other important aspects of equine veterinary and hoof care.
Anyone can nominate an equine vet for the award, which is sponsored by the American Farriers Journal, but selection is completed by previous inductees into the International Equine Veterinarians Hall of Fame. Awards are presented each year during the International Hoof-Care Summit in Cincinnati, Ohio.
Sue said: "I was completely surprised, but absolutely thrilled, to learn that I had been selected to join the distinguished list of people who have previously been appointed to the International Equine Veterinarians Hall of Fame.
"I think it is very humbling to recognise that, despite the knowledge that my team and I have amassed in the last 30 years, there is so much more to learn. From every new finding come many more questions. I hope that the enthusiastic dedication of my team will continue to result in learning and discovering more, and inspire others to do likewise, to the ultimate benefit of the welfare of our great friend, the horse."
Sue has has worked at the AHT for 30 years and is currently researching the association between hindlimb lameness and saddle slip. She has observed some association between the two for several years, however saddle slip has traditionally been attributed to an ill-fitting saddle, asymmetry of the horse's back shape or a crooked rider.
In 2011 Sue carried out a prospective research project with Intern Line Greve: 'Saddle slip may be an indicator of the presence of hindlimb lameness'. It was presented at the 51st Annual Congress of the British Equine Veterinary Association, Birmingham 2012, and identified that in some cases, saddle slip was directly linked to the presence of hindlimb lameness.
Research results showed that of 128 horses assessed for lameness grade and degree of saddle slip when ridden by two riders, the saddle consistently slipped to one side in 54% of the horses with hindlimb lameness, in comparison to just 4% of the horses with forelimb lameness. Diagnostic analgesia to abolish the hindlimb lameness eliminated the saddle slip in 97% of the horses observed in the study.
Sue and Line are currently undertaking further research to measure movement of the back, and forces under the saddle, with the aim of explaining biomechanically what is happening during the occurrence of saddle slip.
The RCVS has launched its new Fellowship scheme and is now accepting applications from veterinary surgeons who have made a meritorious contribution to their particular field.
The new Fellowship scheme was launched with three routes to membership: meritorious contributions to knowledge; meritorious contributions to clinical practice; and meritorious contributions to the profession.
The changes were approved by RCVS Council at its June 2015 meeting, following a public consultation on how the Fellowship could be developed to move it away from being an examination-based award, to becoming a learned society.
Dr Bradley Viner, President of the RCVS, said: "I am very proud to announce the launch of the new Fellowship scheme and I hope that, as a learned body, the Fellowship will help advance and develop clinical and professional standards by sharing their knowledge and expertise with the profession.
"The move from being an examinations-based award to the three new paths to entry is a significant development as it will widen the reach of the Fellowship, particularly to those who are working in clinical practice.
"I would strongly encourage all those who feel they have made a meritorious contribution to any of these three areas to apply as I am very hopeful we will be able to award our first group of new Fellowships at RCVS Day on Friday 15 July."
The criteria for achieving Fellowship includes sustained contribution to scholarship; producing a body of creative work that has been disseminated to others; indisputable advancement of their subject; providing leadership to the profession; and, advancement of the public understanding of the profession.
Each application will be assessed by a Credentials Panel to see if it meets the proposed criteria. Applications approved by the Panel will then be put to the Fellowship Board, which will meet once a year to consider the overall list of proposed applications.
The closing date for initial applications is Wednesday 11 May. Application forms for the three different routes to Fellowship, as well as further details about criteria and a list of relevant doctorate programmes, can be found at www.rcvs.org.uk/fellowship
All current Fellows, including Honorary Fellows, will retain their FRCVS/HonFRCVS status.
For the rankings, QS assessed 1496 programs across the world that offer courses in Veterinary Science, with the RVC placing second out of 427 institutions.
Professor Stuart Reid, Principal of the RVC, said: “Trading 1st and 2nd places with our friends at UC Davis globally, we are still very pleased to retain our ranking as highest placed veterinary school outside the USA.
"With a strong showing from schools in continental Europe and other newcomers to the top 10, the QS rankings emphasise once again the highly competitive nature of our subject internationally.
"We are pleased to record the highest score for academic reputation and an excellent performance in our research impact, and I congratulate Dean Lairmore - himself an honorary Fellow of the RVC - and his colleagues at UC Davis on regaining the top spot but serve notice that we will be seeking to trade again in 2021!”
Sally Linghorn, Senior RVN at CVS and one of the team behind the initiative, said: “As far as we know, no other veterinary company has policy, support and specific training and guidance on this topic, in our female-biased profession.”
“We recognise how devastating pregnancy loss can be.
"Last year we launched a policy to provide special paid leave for pregnancy loss.
"But since implementing this we have noticed a gap.
"We felt our managers needed guidance and support on how to provide the more practical and emotional support on a day-to-day basis, if someone in their team experienced a loss."
The new guidance contains advice on how to understand each individual’s experiences and needs, help in the immediate situation of pregnancy loss at work, treat and record any time off directly related to a loss, understand how pregnancy loss can affect mental health, talk about pregnancy loss, facilitate a return to work and the importance of regular follow-ups and check-ins.
Dermatologist Anthony Chadwick, aka the webinar vet, is offering VetSurgeon members a 30% discount on the cost of a forthcoming series of webinars. Just enter the word vetsurgeon in the discount box at webinarvet.com.
The series kicks off on the 17th June, when John Innes from Liverpool University will be talking about diagnosing forelimb lameness. On the 24th, Alan Robinson will be talking about pet healthcare schemes and on July 1st, Pip Boydell will discuss vestibular disease. Finally, on July 8th, Anthony will close the second series with a look at atopic disease, focusing on new and novel treatments.
For those of you that haven't yet experienced a webinar, and would like to 'try before you buy', there is a free webinar on 10th June (9pm-10pm), in which Martha Cannon, one of only 3 feline specialists in the UK, will present an update on feline infectious disease. Click here to register and if you enjoy the presentation, you will still be able to register for the series at the discounted price.
Every tube of Logic Oral Hygiene Gel now contains a free finger brush to encourage owners to brush their pet's teeth every day.
Ceva Animal Health product manager, Fraser Broadfoot MRCVS, said: "Daily brushing is known to be the single most effective means of removing plaque. The finger brush in each pack of Logic is ideal for administration to cats and small dogs. For medium to large dogs we also have a Logic Dental Care Kit, which includes a tube of Logic Oral Hygiene Gel and a Petosan toothbrush."
Ceva says Logic is the UK's leading veterinary dental brand thanks to high palatability and unique multi-enzyme formula, which works by enhancing the mouth's natural defence systems. In addition, a surfactant ensures that the active ingredient remains in contact with the teeth and gums.
Providing a service for everyone from the richest to the poorest, veterinary surgeons probably have a better insight than most to the effects of inequality in society.
Whilst most people can probably think of one or two government policies which contribute to inequality, Sebastian's fully-referenced book is perhaps the first to identify the entire alphabet's worth, and collate them in an easily digestible format (it's only a 45 minute read).
The book is available in hardback on Amazon for £10, or as an e-book for £5.99
Sebastian is on VetSurgeon.org to answer your questions about and discuss how government policies create inequality in society, here: https://www.vetsurgeon.org/001/nonclinical/f/off-duty-discussions/30455/the-a-z-of-inequality
Although you certainly don't have to have bought or read his book to take part in the discussion, you should find it £5.99 well spent.
https://www.amazon.co.uk/Z-Inequality-Sebastian-Chambers-ebook/dp/B09ZVN1HDW
The training sessions are taking place both online and in person and places will be allocated on a first come first served basis.
Upcoming training dates are as follows:
https://www.vetmindmatters.org/training/
The WSAVA's Global Nutrition Committee (GNC) has launched a Nutrition Toolkit for veterinary professionals.
The non-branded toolkit contains the following materials:
The toolkit is available for download at http://wsava.org/nutrition-toolkit.
Based on its importance to overall health, the WSAVA is campaigning to have a nutritional assessment confirmed as the fifth vital assessment in a standard physical examination and for the veterinary healthcare team to provide nutritional recommendations for each animal as an integral component of patient care.
The launch of the Nutrition Toolkit follows on from the Global Nutrition Committee's first initiative, the creation of a set of Nutrition Guidelines in 2011. These were aimed at helping veterinary professionals and pet owners ensure that pets are fed according to an optimal and individually tailored nutrition plan. According to WSAVA, they have been successful, securing endorsements from 19 veterinary organizations in 16 countries. They have been translated into ten languages and are available for download at http://www.wsava.org/guidelines/global-nutrition-guidelines.
GNC Co-Chair Dr Marge Chandler said: "Research shows that more than 90% of pet owners would like nutritional advice but fewer than 15% feel they receive it. In some parts of the world, pet malnutrition remains a major challenge, while in many other countries, pet obesity is an increasing problem. In addition, there is confusion about optimal nutrition because there is now so much conflicting and inaccurate information available online.
Our Nutrition Toolkit is designed to help the veterinary healthcare team address nutrition at every patient visit and to advance the central role of the veterinary healthcare team as the expert source of nutrition information."