RESUMEN
In this article, we present a case study of sewing as a strategy for arts-based inquiry in health research, situated within a broader project that highlighted Nunavut Inuit women's childbirth experiences. Five focus groups were hosted as sewing sessions with pregnant women (N = 19) in Iqaluit, Nunavut (2017-2018). Women's reflections on the sessions, and the significance of sewing to Inuit, were integrated with researchers' critical reflections to examine the value of sewing as a strategy for arts-based inquiry within a focus group method: results related to the flexibility of the sessions; how collective sewing created space for voicing, sharing, and relating; sewing as a tactile and place-specific practice tied to Inuit knowledge and tradition; and lessons learned. Our results underscore the possibilities of arts-based approaches, such as sewing, to enhance data gathering within a focus group method and to contribute to more locally appropriate, place-based methods for Indigenous health research.
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Inuk , Investigación , Femenino , Grupos Focales , Humanos , Nunavut , EmbarazoRESUMEN
Extant research shows veterinarians face increasing challenges in discussing nutrition with clients despite receiving professional nutrition education in the veterinary medical curriculum. This article's aim is to elicit student veterinarians' baseline nutrition-related perceptions and nutrition information-seeking behaviors at the time of entering veterinary school. Participants were newly enrolled veterinary students at the Ontario Veterinary College (n = 120). Focus group discussions (n = 19) informed the design of an online questionnaire capturing students' demographics and perceptions of their own and their pets' nutrition. Students reported being influenced by individual factors (e.g., time), social networks (e.g., family), and surrounding environment (e.g., cost, contradictory media messages). Overall, 58% of students considered themselves knowledgeable about pet nutrition when commencing veterinary school, with 71% prioritizing their pets' diets as much as their own. Students' confidence in finding pet nutrition information was correlated with perceived accessibility (r = .76, p = .001) and perceived quantity of information available on pet nutrition (r = .83, p = .001), but not quality of information (r = .13, p = .03). In general, students relied on and trusted veterinarians for nutrition advice. However, 94% of students mistrusted pet food companies' motivations. Our data support that students entering veterinary school have their own perceptions on pet nutrition that impact nutrition education, suggesting this as an important consideration in the design and delivery of a veterinary nutrition curriculum. Veterinary medical faculty should be encouraged to discuss baseline nutrition information and address any misconceptions to prepare students for future consultations with clients.
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Educación en Veterinaria , Animales , Curriculum , Humanos , Ontario , Percepción , Mascotas , EstudiantesRESUMEN
BACKGROUND: Race and ethnicity classification systems have considerable implications for public health, including the potential to reveal or mask inequities. Given increasing "super-diversity" and multiple racial/ethnic identities in many global settings, especially among younger generations, different ethnicity classification systems can underrepresent population heterogeneity and can misallocate and render invisible Indigenous people and ethnic minorities. We investigated three ethnicity classification methods and their relationship to sample size, socio-demographics and sexual health indicators. METHODS: We examined data from New Zealand's HIV behavioural surveillance programme for men who have sex with men (MSM) in 2006, 2008, 2011, and 2014. Participation was voluntary, anonymous and self-completed; recruitment was via community venues and online. Ethnicity allowed for multiple responses; we investigated three methods of dealing with these: Prioritisation, Single/Combination, and Total Response. Major ethnic groups included Asian, European, indigenous Maori, and Pacific. For each classification method, statistically significant associations with ethnicity for demographic and eight sexual health indicators were assessed using multivariable logistic regression. RESULTS: Overall, 10,525 MSM provided ethnicity data. Classification methods produced different sample sizes, and there were ethnic disparities for every sexual health indicator. In multivariable analysis, when compared with European MSM, ethnic differences were inconsistent across classification systems for two of the eight sexual health outcomes: Maori MSM were less likely to report regular partner condomless anal intercourse using Prioritisation or Total Response but not Single/Combination, and Pacific MSM were more likely to report an STI diagnosis when using Total Response but not Prioritisation or Single/Combination. CONCLUSIONS: Different classification approaches alter sample sizes and identification of health inequities. Future research should strive for equal explanatory power of Indigenous and ethnic minority groups and examine additional measures such as socially-assigned ethnicity and experiences of discrimination and racism. These findings have broad implications for surveillance and research that is used to inform public health responses.
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Infecciones por VIH , Minorías Sexuales y de Género , Etnicidad , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Humanos , Masculino , Grupos Minoritarios , Salud Pública , Conducta Sexual , Parejas SexualesRESUMEN
Three milestone educational planning initiatives engaged the veterinary medical profession in the United States and Canada between 1987 and 2011, namely the Pew National Veterinary Education Program, the Foresight Project, and the North American Veterinary Medical Education Consortium. In a quantitative study, we investigated the impact of these initiatives on veterinary medical education through a survey of academic leaders (deans, previous deans, and associate deans for academics from veterinary medical schools that are members of the Association of American Veterinary Medical Colleges) to assess their perspectives on the initiatives and eight recommendations that were common to all three initiatives. Two of the recommendations have in effect been implemented: enable students to elect in-depth instruction and experience within a practice theme or discipline area (tracking), and increase the number of graduating veterinarians. For three of the recommendations, awareness of the issues has increased but substantial progress has not been made: promote diversity in the veterinary profession, develop a plan to reduce student debt, and develop a North American strategic plan. Lastly, three recommendations have not been accomplished: emphasize use of information more than fact recall, share educational resources to enable a cost-effective education, and standardize core admissions requirements. The educational planning initiatives did provide collaborative opportunities to discuss and determine what needs to change within veterinary medical education. Future initiatives should explore how to avoid and overcome obstacles to successful implementation.
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Curriculum , Liderazgo , Modelos Educacionales , Técnicas de Planificación , Animales , Canadá , Educación en Veterinaria , Organizaciones de Planificación en Salud , Humanos , Encuestas y Cuestionarios , Estados UnidosRESUMEN
BACKGROUND: Understanding HIV testing behaviour is vital to developing evidence-based policy and programming that supports optimal HIV care, support, and prevention. This has not been investigated among younger gay, bisexual, and other men who have sex with men (YMSM, aged 16-29) in New Zealand. METHODS: National HIV sociobehavioural surveillance data from 2006, 2008, and 2011 was pooled to determine the prevalence of recent HIV testing (in the last 12 months) among YMSM. Factors associated with recent testing were determined using manual backward stepwise multivariate logistic regression. RESULTS: Of 3,352 eligible YMSM, 1,338 (39.9%) reported a recent HIV test. In the final adjusted model, the odds of having a recent HIV test were higher for YMSM who were older, spent more time with other gay men, reported multiple sex partners, had a regular partner for 6-12 months, reported high condom use with casual partners, and disagreed that HIV is a less serious threat nowadays and that an HIV-positive man would disclose before sex. The odds of having a recent HIV test were lower for YMSM who were bisexual, recruited online, reported Pacific Islander or Asian ethnicities, reported no regular partner or one for >3 years, were insertive-only during anal intercourse with a regular partner, and who had less HIV-related knowledge. CONCLUSION: A priority for HIV management should be connecting YMSM at risk of infection, but unlikely to test with appropriate testing services. New generations of YMSM require targeted, culturally relevant health promotion that provides accurate understandings about HIV transmission and prevention.
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Serodiagnóstico del SIDA/estadística & datos numéricos , Bisexualidad/estadística & datos numéricos , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Homosexualidad Masculina/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Adolescente , Adulto , Promoción de la Salud/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Análisis Multivariante , Nueva Zelanda , Vigilancia de la Población , Prevalencia , Sexo Seguro/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Adulto JovenRESUMEN
Samples from 231 randomly selected commercial broiler chicken flocks in Ontario were tested at slaughter for exposure to chicken anemia virus (CAV), fowl adenovirus (FAdV), and infectious bursal disease virus (IBDV). Fifteen blood samples per flock were collected and analyzed for the presence of antibodies against CAV, FAdV, and IBDV by ELISA or agar gel immunodiffusion test. Fifteen cecal tonsils and cloacal swabs per flock were analyzed for the presence of CAV, FAdV, and IBDV by PCR. The prevalence of exposure to avian adeno-associated virus (AAAV) was estimated by a PCR test on a subset of FAdV-PCR-positive samples from 178 flocks. Genotypes of FAdV and IBDV were identified on a subset of isolates (n = 353 and 45, respectively). The flock-level period prevalence of exposure to AAAV, CAV, FAdV, and IBDV during grow-out were 88.76% (95% CI: 84.08-93.45%), 77.06% (95% CI: 71.59-82.52%), 96.54% (95% CI: 94.16-98.91%), and 48.92% (95% CI: 42.42-55.41%), respectively. Results of a multivariable logistic regression model showed a significant association of exposure to FAdV with exposure to AAAV (OR = 18.57, 95% CI: 3.67-93.86, P = 0.004) but not with exposure to CAV (P = 0.7752) or exposure to IBDV (P = 0.2274). Pathogenic FAdV genotypes (FAdV-02, FAdV-08, and FAdV-11) constituted 39.38% of the isolates. The most-common IBDV genotypes identified were IBDV NC171 (60%) and IBDV 05SA8 (28.89%). This is the first large-scale study to estimate the baseline flock prevalence of exposure to AAAV, CAV, FAdV, and IBDV in commercial broiler flocks in Canada. Potentially pathogenic genotypes of FAdV and IBDV that can guide vaccine development and disease control efforts in Ontario were identified.
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Infecciones por Adenoviridae/veterinaria , Infecciones por Birnaviridae/veterinaria , Pollos , Infecciones por Circoviridae/veterinaria , Infecciones por Parvoviridae/veterinaria , Enfermedades de las Aves de Corral/epidemiología , Infecciones por Adenoviridae/epidemiología , Infecciones por Adenoviridae/virología , Animales , Infecciones por Birnaviridae/epidemiología , Infecciones por Birnaviridae/virología , Virus de la Anemia del Pollo/aislamiento & purificación , Infecciones por Circoviridae/epidemiología , Infecciones por Circoviridae/virología , Coinfección/epidemiología , Coinfección/veterinaria , Coinfección/virología , Dependovirus/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática/veterinaria , Adenovirus A Aviar/genética , Adenovirus A Aviar/aislamiento & purificación , Inmunodifusión/veterinaria , Virus de la Enfermedad Infecciosa de la Bolsa/genética , Virus de la Enfermedad Infecciosa de la Bolsa/aislamiento & purificación , Ontario/epidemiología , Infecciones por Parvoviridae/epidemiología , Infecciones por Parvoviridae/virología , Reacción en Cadena de la Polimerasa/veterinaria , Enfermedades de las Aves de Corral/virología , PrevalenciaRESUMEN
BACKGROUND: A high proportion of staphylococci isolated from pigs affected with exudative epidermitis were found to be resistant to ß-lactam antimicrobials. The primary objective of this research was to investigate and characterize ß-lactam resistance in Staphylococcus hyicus, Staphylococcus aureus and other staphylococci isolated from these pigs. RESULTS: The antimicrobial resistance patterns of 240 staphylococci isolates were determined by disk diffusion, of which 176 (73.3%) of the isolates were resistant to 3 ß-lactams (penicillin G, ampicillin, and ceftiofur). The presence of mecA gene was identified in 63 staphylococci isolates from skin samples by PCR. The mecA gene was identified in 19 S. aureus, 31 S. hyicus, 9 Staphylococcus chromogenes, 2 Staphylococcus pseudintermedius isolates, and in 1 isolate each of Staphylococcus arlettae, and Staphylococcus cohnii subspecies urealyticus. From SCCmec typing results, the majority (45/63, 71.4%) were shown to be SCCmec type V. One isolate was SCCmec III. Fourteen isolates were detected as mec class A, mec class C or ccr type 5. The ccr complex and mec complex was not detected in 3 isolates of methicillin resistant S. hyicus (MRSH) based on multiplex PCR. Of the 30 isolates of MRSA identified from nasal samples of the pigs, 29 isolates were SCCmec type V and 1 isolate was SCCmec type II. Staphyloccoci isolates that were mecA negative but resistant to ß-lactam antimicrobials were further examined by screening for mecC, however all were negative. Furthermore, the majority of mecA negative ß-lactam resistant staphylococci isolates were susceptible to oxacillin and amoxicillin-clavulanic acid in a double disk diffusion test. CONCLUSIONS: Methicillin resistance can be identified in a variety of staphylococcal species isolated from pigs. In this study there was a great deal of similarity in the SCCmec types between staphylococcal species, suggesting that resistance may be passed from one species of staphylococci to another species of staphylococci. While this has been reported for acquisition of methicillin-resistance from coagulase negative staphylococci to S. aureus, these data suggest that transmission to or from the porcine pathogen S. hyicus may also occur. The identification of methicillin resistance in a variety of staphylococcal species in pigs does raise concerns about the spread of serious multi-drug resistance in food producing animals and warrants further study.
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Epidermitis Exudativa Porcina/tratamiento farmacológico , Infecciones Cutáneas Estafilocócicas/veterinaria , Staphylococcus aureus/efectos de los fármacos , Staphylococcus hyicus/efectos de los fármacos , Resistencia betalactámica , beta-Lactamas/uso terapéutico , Ampicilina/uso terapéutico , Animales , Técnicas de Tipificación Bacteriana/veterinaria , Cefalosporinas/uso terapéutico , Pruebas Antimicrobianas de Difusión por Disco/veterinaria , Epidermitis Exudativa Porcina/microbiología , Penicilina G/uso terapéutico , Infecciones Cutáneas Estafilocócicas/tratamiento farmacológico , Infecciones Cutáneas Estafilocócicas/microbiología , Staphylococcus/efectos de los fármacos , Staphylococcus/genética , Staphylococcus aureus/genética , Staphylococcus hyicus/genética , Porcinos , Resistencia betalactámica/genéticaRESUMEN
Exudative epidermitis (EE) is a common skin disease of young pigs, caused mainly by Staphylococcus hyicus. Increased prevalence of EE and poor response to treatment are reported. Common strategies used by Ontario pork producers to treat pigs with EE were determined using a survey. Injection of penicillin G was reported as the most common parenteral antibiotic choice. Antimicrobial resistance patterns of S. hyicus and Staphylococcus aureus isolated from clinical cases (30 herds with samples from approximately 6 pigs per farm) showed that 97% of S. hyicus isolates were resistant to penicillin G and ampicillin; 71% of these isolates were resistant to ceftiofur. Similar resistance was noted among S. aureus isolates. Antimicrobial resistance has become a problem in the treatment of EE in Ontario.
Enquête sur l'épidermite exsudative (eczéma séborrhéique du porc) et les tendances d'antibiorésistance deStaphylococcus hyicuset deStaphylococcus aureusisolés des cas cliniques. L'épidermite exsudative (EE) est une maladie cutanée courante des porcelets qui est causée principalement par Staphylococcus hyicus. Une prévalence accrue d'EE et une réponse mitigée au traitement sont signalées. Les stratégies couramment utilisées par les producteurs de porcs pour traiter les porcs atteints d'EE ont été déterminées à l'aide d'un sondage. L'injection de pénicilline G a été signalée comme le choix d'antiobiotique parentéral le plus courant. Les tendances d'antibiorésistance de S. hyicus et de Staphylococcus aureus isolés de cas cliniques (30 troupeaux avec des échantillons provenant d'environ 6 porcs par ferme) ont montré que 97 % des isolats de S. hyicus étaient résistants à la pénicilline G et à l'ampicilline; 71 % de ces isolats étaient résistants au ceftiofur. Une résistance semblable a été signalée pour les isolats de S. aureus. L'antibiorésistance est devenue un problème dans le traitement d'EE en Ontario.(Traduit par Isabelle Vallières).
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Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Infecciones Cutáneas Estafilocócicas/veterinaria , Staphylococcus aureus/efectos de los fármacos , Staphylococcus hyicus/efectos de los fármacos , Enfermedades de los Porcinos/microbiología , Animales , Ontario/epidemiología , Infecciones Cutáneas Estafilocócicas/epidemiología , Infecciones Cutáneas Estafilocócicas/microbiología , Infecciones Cutáneas Estafilocócicas/patología , Porcinos , Enfermedades de los Porcinos/epidemiología , Enfermedades de los Porcinos/patologíaRESUMEN
OBJECTIVE: To examine the prevalence and context of one-health conversations between veterinarians and clients in companion animal practice. SAMPLE: A random selection of 60 companion animal veterinarians; a convenience sample of 917 interactions from Southern Ontario, Canada. Of these, 100 audio-video-recorded interactions including 47 of 60 veterinarians were randomly selected for inclusion in this study. METHODS: Audio-video recordings were made of veterinarian-client-patient interactions between November 2017 and January 2019. A researcher-generated coding framework was developed and used to assess the prevalence and content of one-health topics communicated during veterinary appointments. RESULTS: Of the interactions assessed, 60 were preventive care and 40 were health problem appointments. Further, 78% (78/100) included at least 1 discussion related to one health. One-health topics included zoonoses (28% [28/100]), animal behavior (25% [25/100]), illness/disease (20% [20/100]), activity level/exercise (16% [16/100]), nutrition (16% [16/100]), dentistry (6% [6/100]), body weight (3% [3/100]), animal welfare (3% [3/100]), dog/cat bites (2% [2/100]), cannabis (2% [2/100]), and aging (1% [1/100]). Zoonotic diseases were mentioned in 65 appointments, 28 of which evolved into a one-health discussion. Antibiotics were discussed in 27 appointments, none of which were discussed in relation to one health (eg, antimicrobial resistance). CLINICAL RELEVANCE: Findings suggest that one-health topics are raised within most veterinary appointments. Opportunities exist for more comprehensive one-health conversations between veterinarians and their clients, particularly in relation to zoonotic diseases and antimicrobials.
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Comunicación , Salud Única , Veterinarios , Animales , Gatos , Perros , Humanos , Enfermedades de los Perros , Relaciones Interpersonales , Ontario , Mascotas , ZoonosisRESUMEN
BACKGROUND: Reviewing patient health parameter trends can strengthen veterinarian-client-patient relationships. The objective of this study is to identify characteristics associated with veterinarians' communication of health parameter trends to companion animal clients. METHODS: Using a sequential exploratory mixed methods design, independent pet owner (n = 27) and veterinarian (n = 24) focus groups were conducted and analysed via content analysis to assess perceptions of how health parameter trends are communicated by veterinarians. Subsequently, a quantitative assessment of video recorded veterinary appointments (n = 917) compared characteristics identified in focus groups with health parameter trend discussions in practice. A mixed logistic model was used to assess characteristics associated with the occurrence of weight trend discussions. RESULTS: Fifteen characteristics relating to veterinarians' use of health parameter trends were identified across focus groups. Veterinarians discussed 77 health parameter trends in relation to bodyweight (57/77), blood work (15/77) and other health parameters (5/77), within 73 (73/917) appointments. The odds of a weight trend discussion were higher if the veterinarian identified the pet as overweight or obese compared to an ideal bodyweight (odds ratio (OR) = 2.17; 95% confidence interval (CI) = 1.15-4.09; p = 0.016). CONCLUSION: Mention of a health parameter trend was uncommon and rarely included use of visual aids. Health parameter trends related to bodyweight were discussed reactively, rather than proactively.
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Mascotas , Veterinarios , Animales , Comunicación , Grupos Focales , HumanosRESUMEN
OBJECTIVES: To investigate the effect of cooking with an iron ingot on the iron content of several water and Cambodian food preparations. METHODS: Various food and water samples were prepared, in replicate, in glass and aluminium pots with and without an iron ingot. The samples were subjected to iron content analysis using standard ICP-OES procedures. RESULTS: Prepared with an ingot, the iron content was 76.3 µg iron/g higher in lemon water, 32.6 µg iron/g higher in pork soup and 3.3 µg iron/g higher in fish soup, than in the same foods prepared without an ingot. Acidity of the food samples was positively associated with iron leaching. CONCLUSIONS: Even when taking into account the low bioavailability of contaminant iron, approximately 75% of the daily iron requirement can be met by consuming 1L of lemon water prepared with an iron ingot. Its use may be a cheap and sustainable means of improving iron intake for those with iron-deficient diets.
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Culinaria/métodos , Análisis de los Alimentos , Hierro/análisis , Oligoelementos/análisis , Agua/análisis , Aluminio , Cambodia , Utensilios de Comida y Culinaria , Vidrio , HumanosRESUMEN
BACKGROUND: More than 3.5 billion people are affected by iron-deficiency anaemia (IDA). Previous studies have shown that the use of iron pots in daily cooking ameliorates IDA. We report a study on the use of a novel treatment to address IDA in rural women in Cambodia, where the use of iron pots is not common. METHODS: A community-wide randomized controlled trial was conducted in the village of Preak Ruessei, Kandal Province, Cambodia. Rural women (n = 189) were enrolled and randomly assigned by household to one of three groups: (i) control, (ii) iron treatment with no follow-up and (iii) iron treatment with follow-up visits to provide IDA education. Haemoglobin, serum iron and C-reactive protein concentrations were measured at baseline, 3 and 6 months. A reusable fish-shaped iron ingot was distributed to the two treatment groups and participants were directed to use them daily for cooking. We hypothesized that iron from the ingot would leach iron into food providing an effective iron source. RESULTS: Blood iron levels were higher in women in the iron fish plus follow-up at 3 months compared with controls, but this was not maintained. At 6 months, haemoglobin and serum iron had fallen in all groups and the proportion of anaemic women had increased. CONCLUSIONS: This study shows that the iron ingot was effective in the short but not longer-term against IDA. Though a novel treatment option, further research is warranted to determine bioavailability of leached iron and whether or not the surface area is large enough for sufficient iron leaching.
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Anemia Ferropénica/terapia , Culinaria/métodos , Suplementos Dietéticos , Hierro/uso terapéutico , Salud Rural , Adulto , Anemia Ferropénica/epidemiología , Proteína C-Reactiva/análisis , Cambodia/epidemiología , Femenino , Hemoglobinas/análisis , Humanos , Hierro/administración & dosificación , Estudios Longitudinales , Persona de Mediana Edad , Educación del Paciente como Asunto/métodos , Factores SocioeconómicosRESUMEN
BACKGROUND: Blood tests play a vital role in veterinary medicine, as they enable veterinarians to make decisions about their patients' medical care and provide opportunities to engage clients in veterinary care. The objective of this study was to explore perspectives of veterinary clients and veterinarians on current reporting practices for blood tests ordered in companion animal practice. The type of information communicated and client information seeking behaviours were examined. METHODS: Two online surveys were distributed using snowball sampling: one targeting veterinary clients and one targeting veterinarians. RESULTS: In total, 529 veterinary client and 416 veterinarian surveys were included in analyses. Significant differences were found between what blood test information veterinarian respondents felt they provided clients and what client respondents perceived they received with regard to their pet's blood tests. Almost 60% of clients somewhat or strongly agreed that they search the Internet if they do not understand why a test was ordered or what the results mean. Half of clients reported that they never receive a written report of their pet's blood work, 81% of whom were interested in receiving a copy. CONCLUSION: Results of this research demonstrate opportunities to improve veterinarians' and clients' communication about blood tests.
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Veterinarios , Animales , Comunicación , Pruebas Hematológicas/veterinaria , Humanos , Mascotas , Encuestas y CuestionariosRESUMEN
One of the most complex aspects of the veterinarian-client-patient interaction is the clinical decision-making process. Research suggests that the approach to communication used by veterinarians can impact veterinary clients' involvement in the decision-making process and their ultimate satisfaction. Using different approaches to the decision-making process may affect how information is exchanged and consequently how decisions are made. The objective of this study was to determine pet owners' expectations with respect to information exchange and decision-making during veterinarian-client-patient interactions and to compare veterinarians' perceptions of those expectations and the challenges they face in meeting them. Five pet owner focus groups (27 owners) and three veterinarian focus groups (24 veterinarians) were conducted with standardized open-ended questions and follow-up probes. Thematic analysis of the transcribed data was conducted to identify trends and patterns that emerged during the focus groups. Three pet owner-based themes were identified: 1) understanding the client; 2) providing information suitable for the client; and 3) decision-making. In addition, three barriers for veterinarians affecting information exchange and decision-making were identified: 1) time constraints; 2) involvement of multiple clients; and 3) language barriers. Results suggest that pet owners expect to be supported by their veterinarian to make informed decisions by understanding the client's current knowledge, tailoring information and educating clients about their options. Breakdowns in the information exchange process can impact pet owners' perceptions of veterinarians' motivations. Pet owners' emphasis on partnership suggests that a collaborative approach between veterinarians and clients may improve client satisfaction.
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Toma de Decisiones Clínicas , Comunicación , Toma de Decisiones , Propiedad , Percepción , Mascotas , Veterinarios/psicología , Animales , Femenino , Grupos Focales , Humanos , Masculino , Motivación , Satisfacción del Paciente , Proyectos Piloto , Encuestas y CuestionariosRESUMEN
BACKGROUND: Communication practices used by veterinarians can impact client's involvement in decision-making. The objective of this study was to evaluate the level of client involvement in veterinary care decisions and factors impacting client involvement. METHODS: A random sample of practising companion animal veterinarians and a convenience sample of pet owners were recruited. Each consultation was audio-video recorded and analyzed using the Observer OPTION5 instrument, adapted from human medicine, to assess veterinarians' level of shared decision-making. A mixed linear model was used to assess statistical associations between veterinarian, client and appointment-level factors and OPTION5 scores. RESULTS: Sixty veterinarians and 909 of their clients were audio-video recorded during a consultation, of which 717 interactions included a decision identified for analysis using the OPTION5 instrument. Elements consistent with shared decision-making were uncommon, with a mean OPTION5 score of 22.6 (median = 20.0; sd = 13.05; range = 0-75) out of 100. OPTION5 scores were positively associated with the length of the appointment and negatively associated with the veterinarian's years in practice when controlling for statistical interaction between client income and appointment type. CONCLUSION: Findings suggest an opportunity exists for veterinarians to incorporate more client involvement through increased use of shared decisionmaking behaviours during veterinary consultations.
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Veterinarios , Animales , Comunicación , Humanos , MascotasRESUMEN
OBJECTIVE: To assess handling techniques commonly used during routine examinations and procedures used for calm, fearful, and aggressive cats by veterinarians and nonveterinarian staff at Canadian and US veterinary practices and to evaluate demographic factors associated with those handling techniques. SAMPLE: 310 veterinarians and 944 nonveterinarians who handle cats at Canadian and US veterinary practices. PROCEDURES: An online questionnaire was developed to evaluate respondent demographics and use of common cat handling practices and techniques. A snowball sampling method was used to send a link to the questionnaire to members of Canadian and US veterinary-affiliated groups. Descriptive statistics were generated; logistic regression was used to identify demographic factors associated with the use of minimal and full-body restraint with scruffing during routine examination and procedures for fearful and aggressive cats. RESULTS: Full-body restraint was used to handle cats of all demeanors, although its frequency of use was greatest for fearful and aggressive cats. Veterinarians and nonveterinarians who graduated from veterinary training programs before 2006 were less likely to use full-body restraint for cats of all demeanors, compared with nonveterinarians who did not graduate or graduated between 2006 and 2015. Other factors associated with decreased use of full-body restraint included working at an American Association of Feline Practitioners-certified practice and working at a Canadian practice. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that full-body restraint is commonly used to handle cats. Further research is necessary to determine whether current handling recommendations are effective in decreasing stress for cats during veterinary visits.
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Hospitales Veterinarios , Veterinarios , Animales , Canadá , Gatos , Estudios Transversales , Humanos , Encuestas y Cuestionarios , Estados UnidosRESUMEN
OBJECTIVE: To evaluate the influence of owner presence on behavioral and physiologic indicators of fear in dogs during routine physical examinations. ANIMALS: 32 client-owned dogs. PROCEDURES: Dogs underwent a standardized, video-recorded examination consisting of 6 phases (examination of the head, lymph node palpation, body palpation, axillary temperature measurement, heart rate assessment, and respiratory rate assessment) with or without their owner present in a randomized, controlled study. Behaviors reported to be indicative of fear, including reduced posture, avoidance, escape, lip licking, body shaking, yawning, and vocalizing, were assessed during each phase, and physiologic measurements were assessed during relevant phases by the investigator. Owner presence and sex and age of dogs were investigated for associations with behavioral signs of fear; behavioral and physiologic measurements were compared between groups (owner present vs owner absent). RESULTS: Dogs in the owner-present group had a lower rate of vocalizations, lower mean axillary temperature, and higher rate of yawning than dogs in the owner-absent group. Female dogs in the owner-absent group had a higher heart rate than females and males in the owner-present group and males in the owner-absent group, and the rate of lip licking decreased as age increased in the owner-present group. The presence of reduced body posture and rates of lip licking, avoidance behavior, and escape behavior were associated with examination phase. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that, when practical, owners should be encouraged to remain with their dog during routine veterinary examinations. However, effects of owner presence during procedures require further investigation. (J Am Vet Med Assoc 2020;257:1031-1040).
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Temperatura Corporal , Miedo , Animales , Perros , Femenino , Frecuencia Cardíaca , MasculinoRESUMEN
BACKGROUND: Beliefs of pet owners strongly influence their decision-making surrounding their pets' diet. Thus, nutritional guidance is an essential component of veterinary practice and integral to managing rising rates of pet obesity. This study examined pet owners' trust of, perceived effectiveness of, and intentions to follow nutritional guidance received from their veterinarian in managing their pets' diet. METHODS: A cross-sectional study of 1402 dog and cat owners in the USA and Canada was conducted using an online questionnaire tool. Data were analysed using descriptive statistics and logistic regression modelling. RESULTS: Clients are concerned about the effectiveness of veterinary nutrition recommendations. Cat owners were more likely than dog owners to consider the nutritional guidance they receive from veterinarians effective for their pets' diet (1.75, P=0.04). Length of pet ownership, feeding dry diets and frequency of veterinary visits were all positively associated with owners considering veterinary nutritional guidance to be effective in managing pets' diet. CONCLUSION: Identifying these perspectives can aid in developing strategies to provide nutrition support to pet owners to improve their perceptions of, self-efficacy with, and compliance with veterinary nutrition recommendations.
Asunto(s)
Ciencias de la Nutrición Animal , Actitud , Mascotas/psicología , Relaciones Profesional-Familia , Veterinarios/psicología , Adulto , Anciano , Anciano de 80 o más Años , Animales , Canadá , Gatos , Consejo , Estudios Transversales , Perros , Femenino , Humanos , Intención , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Estados Unidos , Adulto JovenRESUMEN
Veterinarians play a critical role in providing nutrition consultation and supporting clients to adopt healthy dietary habits for their pets; thus applicable, informative nutrition education in veterinary schools is essential. The aim of this study was to explore incoming veterinary students' perceived importance, emphasis, and confidence in the veterinary nutrition education they will receive. First-year veterinary students at all 5 Canadian and 5 randomly selected US veterinary schools were invited to complete a 31-item questionnaire. Response rate was 34.6% (n = 326). Descriptive statistics and multivariate logistic regression were performed. While most students (92%) considered nutrition education to be an important component of veterinary training, 64% felt it will not be a subject of great emphasis. Veterinary students at schools with a board-certified veterinary nutrition faculty were more likely to perceive higher emphasis on nutrition education (p < 0.001). In the multivariate analysis, academic self-efficacy was a positive predictor of students' perceived confidence in how well they anticipate their nutrition education that will prepare them for their clinical roles (p = 0.003). Examining the perceptions of veterinary students entering veterinary school is an important aspect to consider in the design and delivery of a veterinary nutrition curriculum and maybe equally important for students entering other professional health programs.
RESUMEN
Use of scruffing and scruffing tools (eg, clipnosis clips) to immobilise cats is contentious, and cat handling guidelines vary in recommendations regarding these techniques. The current study examined whether cats show negative responses to the following restraint methods: (1) scruff (n=17), (2) clip application to the dorsal neck skin (n=16) and (3) full body (a known negative; n=19). Each cat was also handled with passive restraint (control) for comparison. During handling, cats were examined for behavioural (side/back ear positions, vocalisations, lip licking) and physiological (pupil dilation ratio, respiratory rate) responses. Full-body restrained cats showed more negative responses than passively restrained cats (respiratory rate: p=0.006, F3,37=4.31, p=0.01; ear p=0.002, F3,49=6.70, p=0.0007; pupil: p=0.007, F3,95=14.24, p=0.004; vocalisations: p=0.009, F3,49=4.85, p=0.005) and scruff-restrained cats (pupil: p=0.009; vocalisations: p=0.04). Clip restraint resulted in more negative responses than passive (pupil: p=0.01; vocalisations: p=0.007, ear p=0.02) and scruff restraint (pupil p=0.01; vocalisations: p=0.02). No differences were detected between full-body restraint, known to be aversive, and clip restraint. Full-body restraint and clip restraint resulted in the greatest number of negative responses, scruffing resulted in fewer negative responses and passive restraint showed the least number of responses. We therefore recommend against the use of full-body and clip restraint, and suggest that scruff restraint should be avoided when possible.