Beginning with the End in Mind: Creating a Practice that Centers Equity-Part 2.

The concept of equity recognizes historical and current barriers and promotes thriving for veterinary teams and people and animals in the community. It is possible to design equitable workplace systems to prevent and respond to harm using learnings from human medicine and the social sciences. These systems are grounded in the principles of health equity and must incorporate both formal policies and intentional cultivation of supportive culture and relationships. This article is part 2 of 2 articles reviewing how the concept of equity applies and could transform well-being in companion animal veterinary practice in North America.

Causes of admission, length of stay and outcomes for common kestrels in rehabilitation centres in the Czech Republic.

Rehabilitation centres help injured animals to recover and return back to the wild. This study aimed to analyse trends in intake and outcomes for the common kestrels (Falco tinnunculus) admitted into rehabilitation centres in the Czech Republic. From 2010 to 2019, a total of 12,923 kestrels were admitted to 34 rehabilitation centres with an increasing trend (rSp = 0.7697, P < 0.01) being found during the monitored period. Subadult kestrels (34.70%) and kestrels injured by power lines (26.57%) were most often admitted. Most kestrels in the rehabilitation centres died or had to be euthanized (81.66%), only 15.90% of the birds could be released back into the wild. The median length of stay in rehabilitation centres for kestrels that were subsequently released was 35 days. Considering survival rates, the most critical threat to kestrels was poisoning (100% of the cases resulted in death) but mortality of the kestrels admitted for most other reasons also exceeded 80%. Given the low success rate of the care of kestrels in rehabilitation centres and the relatively small proportion returned to the wild, it is essential to eliminate the causes leading to their admission, that is, to protect their natural habitats and to prevent unnecessary capture.

Integrating data of veterinarians' practices in assessing the cost effectiveness of three components of the bovine tuberculosis surveillance system by intradermal tuberculin testing in French cattle farms through a scenario-tree approach.

Disease surveillance systems' effectiveness relies on participants following prescribed practices. We developed a general method to improve a previous cost-effectiveness evaluation of three French screening program protocols for bovine tuberculosis (bTB) to account for the practices of participants by scenario tree modelling. This method relies on: 1) semi-directive interviews of participants to identify the variability of practices and potentially influential factors, and to understand the sociological context; 2) a quantitative survey, based on multiple-choice questions, to quantify various practices and identify significantly influential factors by multivariable regression analyses; 3) addition of the scenario-tree nodes corresponding to the practices and their influential factors and configuration of the new limbs according to the data of the quantitative survey. We used this approach to integrate data concerning veterinary practices and identify some failures to conform to regulatory guidelines regarding intradermal cervical comparative tuberculin test (SICCT) (testing and notification of non-negative results). Such nonconformities appeared to be mainly caused by cattle restraint issues and the perception of veterinarians of the bTB control program. Indeed, their perception of that program significantly influenced veterinarians' practices. We modelled the influence of the SICCT practices on the SICCT results. The incorporation of these data led to a major decrease of the herd sensitivity estimations relative to the previous assessments that did not incorporate data of practices (15% to 42% decrease). This result shows the important impact of veterinarians' practices and their influencing factors (such as perception of the bTB control program) on the effectiveness of the surveillance system.

Herd management and welfare assessment of dairy goat farms in Northern Cyprus by using breeding, health, reproduction, and biosecurity indicators.

This study describes the results of a farm-based welfare assessment, herd management, and some yield indicators in Northern Cyprus dairy goat farms. Out of 324 intensive milk goat farms which produce goats, only the 42 goat farms which had 7950 heads were chosen by random sampling in Northern Cyprus (2016), and face-to-face questionnaires and observations were conducted to collect data. Regarding the breeding techniques in these farms, of all the goats in these farms, 45.2% were cross-breed, 38.1% were Damascus, 11.9% were Saanen, and 4.8% were hair goats. The average of the total number of animals was 211.38 ± 209 heads. The average number of pens and the number of animals per pen in the farms, which had 2 to 5 pens, were 67 ± 49.5 heads. The barn types of these farms were observed to be semi-open and nearly open (95%). 45.5% of the farms made a single milking in a day. The most significant reason for this was that the suckling of the kids lasted 3 months or more in 73.8% of the farms. Natural random mating was applied to 69% of the farms. The 45.2% of the farms applied additional feeding before the mating season. The rate of multiple births was 24.76%. The mortality rate in kids was greater than 10% in the 57% of farms examined. The 75% of kids had diarrhea, 33% had umbilicus infections, and 33% suffered from respiratory problems. Among the adult goats of the surveyed farms, the most important problem was external parasites (100%). The second and third problems were overgrown claws (80.9%) and common abscesses (80.95%). Regarding the biosecurity indicators, the general disinfection percentage of farms was 78.57%. However, veterinarian controls were conducted only in the 26.9% of the farms on a regular basis. In these farms, there was no significant difference between the breeds regarding their breeding and reproduction techniques or health indicators. The entrance of the farms carries a high risk for biosecurity. Heat stress is quite important factor for the milk quality.

Validation of text-mining and content analysis techniques using data collected from veterinary practice management software systems in the UK.

Electronic patient records from practice management software systems have been used extensively in medicine for the investigation of clinical problems leading to the creation of decision support frameworks. To date, technologies that have been utilised for this purpose such as text mining and content analysis have not been employed significantly in veterinary medicine. The aim of this research was to pilot the use of content analysis and text-mining software for the synthesis and analysis of information extracted from veterinary electronic patient records. The purpose of the work was to be able to validate this approach for future employment across a number of practices for the purposes of practice based research. The approach utilised content analysis (Prosuite) and text mining (WordStat) software to aggregate the extracted text. Text mining tools such as Keyword in Context (KWIC) and Keyword Retrieval (KR) were employed to identify specific occurrences of data across the records. Two different datasets were interrogated, a bespoke test dataset that had been set up specifically for the purpose of the research, and a functioning veterinary clinic dataset that had been extracted from one veterinary practice. Across both datasets, the KWIC analysis was found to have a high level of accuracy with the search resulting in a sensitivity of between 85.3-100%, a specificity of between 99.1-99.7%, a positive predictive value between 93.5-95.8% and a negative predictive value between 97.7-100%. The KR search, based on machine learning, was utilised for the clinic-based dataset and was found to perform slightly better than the KWIC analysis. This study is the first to demonstrate the application of content analysis and text mining software for validation purposes across a number of different datasets for the purpose of search and recall of specific information across electronic patient records. This has not been demonstrated previously for small animal veterinary epidemiological research for the purposes of large scale analysis for practice-based research. Extension of this work to investigate more complex diseases across larger populations is required to fully explore the use of this approach in veterinary practice.

Barriers to and enablers of implementing antimicrobial stewardship programs in veterinary practices.

BACKGROUND: Antimicrobial stewardship (AMS) programs are yet to be widely implemented in veterinary practice and medical programs are unlikely to be directly applicable to veterinary settings. OBJECTIVE: To gain an in-depth understanding of the factors that influence effective AMS in veterinary practices in Australia. METHODS: A concurrent explanatory mixed methods design was used. The quantitative phase of the study consisted of an online questionnaire to assess veterinarians' attitudes to antimicrobial resistance (AMR) and antimicrobial use in animals, and the extent to which AMS currently is implemented (knowingly or unknowingly). The qualitative phase used semi-structured interviews to gain an understanding of the barriers to and enablers of AMS in veterinary practices. Data were collected and entered into NVivo v.11, openly coded and analyzed according to mixed methods data analysis principles. RESULTS: Companion animal, equine, and bovine veterinarians participated in the study. Veterinary practices rarely had antimicrobial prescribing policies. The key barriers were a lack of AMS governance structures, client expectations and competition between practices, cost of microbiological testing, and lack of access to education, training and AMS resources. The enablers were concern for the role of veterinary antimicrobial use in development of AMR in humans, a sense of pride in the service provided, and preparedness to change prescribing practices. CONCLUSION AND CLINICAL IMPORTANCE: Our study can guide development and establishment of AMS programs in veterinary practices by defining the major issues that influence the prescribing behavior of veterinarians.

A method for extracting electronic patient record data from practice management software systems used in veterinary practice.

BACKGROUND: Data extracted from electronic patient records (EPRs) within practice management software systems are increasingly used in veterinary research. The use of real patient data gives the potential to generate research that can readily be applied to clinical practice. The use of veterinary EPRs for research in the United Kingdom is hindered by the number of different Practice Management System (PMS) providers used by practices, as obtaining and combining data from different systems electronically can be problematic. The use of extensible mark up language (XML) to extract clinical data for research would potentially resolve the compatibility issues between systems. The aim of this study was to establish and validate a method for the extraction of small animal patient records from a veterinary PMS that could potentially be used across multiple systems. An XML schema was designed to extract clinical information from EPRs. The schema was tested and validated in a test system, and was then tested in a real small animal practice where data was extracted for 16 weeks. A 10 % sample of the extracted records was then compared to paper copies provided by the practice. RESULTS: All 21 fields encoded by the XML schema, from all of the records in the test system, were extracted with 100 % accuracy. Over the 18 week data collection period 4946 records, from 1279 patients, were extracted from the small animal practice. The 10 % printed records checked and compared with the XML extracted records demonstrated all required data was present. No unrequired, sensitive information e.g. costs or services/products or personal client information was extracted. CONCLUSIONS: This is the first time a method for data extraction from EPRs in veterinary practice using an XML schema has been reported in the United Kingdom. This is an efficient and accurate way of extracting data which could be applied to all PMSs nationally and internationally.