Alberta dairy farmers' and veterinarians' opinion about bovine leukemia virus control measures.

A high herd and within-herd prevalence of Bovine Leukemia Virus (BLV) infections in the dairy herds of North America and the negative effects thereof caused the Alberta dairy industry to initiate the development of an on farm BLV control program. Because BLV control is dependent on the commitment of the farmer, potential barriers were identified and farmers' and veterinarians' points of view toward different control options were investigated to inform how the control program might be adjusted. Conversations with these stakeholders were sought and four focus groups with farmers and eleven interviews with veterinarians were conducted. Testing for BLV, the most common BLV control strategies (testing/culling/segregation/management), as well as on farm best management practices (BMP) to prevent the transmission of BLV, were discussed. The thematic analysis of these conversations resulted in the following findings: Testing of animals was considered important for BLV control, but the financial investment was prohibitive for farmers. Test and cull as well as test and segregation approaches of test positive animals were considered efficient BLV control measures, but impractical and not feasible due to the supply managed Alberta dairy industry (i.e. milk is produced based on demand), with a high prevalence. The management of test positive animals with BMP to prevent new infections and thereby decreasing the within-herd prevalence was considered the only realistic BLV control strategy. The most important barriers for suggested BMP were the cost for some BMP, the inconvenience of performing other BMP, as well as difficulties in performing some BMP consistently and well. Additionally, a lack of knowledge about BLV and its control were identified as an important barrier. On the contrary, farmers indicated being inclined to implement BMP they considered feasible or that were considered a standard within the industry. Further, if BMP increased convenience on farm, they were considered easy to implement. Farmers and veterinarians agreed in many, but not all cases. For example, the single use of examination sleeves was met with differing opinions (i.e. considered doable by farmers while veterinarians assumed it to be too costly). In conclusion, stakeholders' awareness and communication amongst each other (e.g. veterinarians and farmers) about BLV and its control has to be highlighted in order to manage BLV infection successfully. In addition, by communicating and understanding barriers and motivators for specific BMP, important barriers could be identified (e.g. difficulties while changing needles), and solutions found (e.g. tool belt for needles), thereby improving BLV control efforts on farm.

Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice.

OBJECTIVE: To explore the relationship between veterinarian-client-patient interactions and client adherence to dental and surgery recommendations and to test the a priori hypotheses that appointment-specific client satisfaction and relationship-centered care are positively associated with client adherence. DESIGN: Cross-sectional study. SAMPLE: A subsample of 19 companion-animal veterinarians and 83 clients from a larger observational study consisting of 20 randomly recruited veterinarians and a convenience sample of 350 clients from eastern Ontario. PROCEDURES: Videotaped veterinarian-client-patient interactions containing a dentistry recommendation, surgery recommendation, or both were selected for inclusion from the larger sample of interactions coded with the Roter interaction analysis system. Client adherence was measured by evaluating each patient's medical record approximately 6 months after the videotaped interaction. The clarity of the recommendation, appointment-specific client-satisfaction score, and relationship-centered care score were compared between adhering and nonadhering clients. RESULTS: Among the 83 veterinarian-client-patient interactions, 25 (30%) clients adhered to a dentistry recommendation, surgery recommendation, or both. The odds for adherence were 7 times as great for clients who received a clear recommendation, compared with clients who received an ambiguous recommendation from their veterinarian. Moreover, adhering clients were significantly more satisfied as measured after the interview. Interactions resulting in client adherence also had higher scores for relationship-centered care than did interactions leading to nonadherence. CONCLUSIONS AND CLINICAL RELEVANCE: Veterinarian use of a relationship-centered care approach, characterized as a collaborative partnership between a veterinarian and a client with provision of clear recommendations and effective communication of the rationale for the recommendations, has positive implications for client adherence.