Cross-sectional survey of sources of information accompanying veterinary product advertisements in two professional print publications.

BACKGROUND: Veterinarians should be able to easily access scientific evidence about medical products and devices to incorporate into their clinical decision making. While the characteristics and quality of supporting information accompanying device and pharmaceutical advertisements have been studied in human medicine, little is known about this topic in veterinary medicine. The aim of this study was to characterise the supporting information provided by manufacturers of prescribed products, tests or devices in promotional material found in two commonly read UK-based veterinary publications. METHODS: Advertisements contained in issues of two veterinary periodicals published between July 2017 and July 2018 were analysed for advertisement and product characteristics and for items of accompanying information. Literature searches were conducted to assess the availability of peer-reviewed sources of information on advertised products. RESULTS: A minority (16%) of the 451 analysed advertisements were accompanied by references to peer-reviewed literature, despite the availability of scientific literature for many of the products advertised. LIMITATION: This study sampled two professional publications over a narrow time period. CONCLUSIONS: There may be insufficient evidence being provided to veterinary professionals via marketing features; this may limit the accessibility of scientific information for clinical decision making around advertised products.

Ethical challenges experienced by veterinary practitioners in relation to adverse events: Insights from a qualitative study.

BACKGROUND: Understanding ethical challenges experienced in relation to adverse events is necessary to inform strategies that optimise patient safety and practitioner wellbeing. METHODS: A qualitative exploration of UK veterinary practitioners' experiences of adverse events was conducted. Data were collected via 12 focus groups and 20 interviews and analysed using an inductive coding technique. RESULTS: Questions surrounding acceptable boundaries of care, decision-making autonomy, personal scope of practice, use of evidence and speaking up about patient safety concerns were identified as ethically challenging to practitioners when endeavouring to prevent adverse events. Issues of appropriate accountability, interaction and communication with animal owners and the prioritisation of emotional and technical support for themselves and others were identified as ethically challenging in the aftermath of adverse events. LIMITATIONS: The qualitative nature of this study limits the generalisability of the findings. CONCLUSIONS: Ethical challenges are experienced by veterinary practitioners in relation to both preventing and responding in the aftermath of adverse events. Strategies that facilitate ethical decision making and reflection and encourage openness and learning from adverse events would likely improve patient safety and enhance practitioner wellbeing. Further research is needed to develop and implement support for practitioners who experience ethical challenges in relation to adverse events.

Factors within A Veterinarian-Cattle Farmer Relationship That May Impact on Biosecurity Being Carried out on Farms: An Exploratory Study.

Veterinarians (vets) appear to be one of the main gateways to biosecurity information for cattle farmers, and therefore are likely to affect the implementation of these measures. The aim of this study was to explore factors within the vet-farmer relationship that may impact on biosecurity being carried out on cattle farms in England. Interviews were conducted with cattle farmers and large-animal vets, with a focus on individuals deemed to implement good levels of biosecurity or those working with said individuals. The questions explored how each stakeholder felt the communication occurred between the groups and the perceived consequential influence each had on the other. Inductive Thematic analysis was used to explore participants' experience of vet-farmer interactions with a focus on areas of reciprocity between the two groups. Five primary themes were identified. Factors within the vet-cattle farmer relationship, such as trust and familiarity, which were interconnected with time spent with each other, appeared to influence the uptake of biosecurity measures on cattle farms. These factors purportedly impacted the ability of vet-farmer pairs to have cooperative discussions and enter into shared decision-making. In order to enhance animal and human health and welfare, these relationship factors might be key to the development of sustainable optimisation frameworks.

The use of theories, models, and frameworks to inform the uptake of evidence-based practices in veterinary medicine - a scoping review.

Evidence-based practices (EBPs) provide strategies to improve the health, welfare and productivity of animal species. However, ensuring implementation and uptake into routine practice of these EBPs is often challenging. In human health research, one approach used to improve uptake of EBPs is the use of theories, models and/or frameworks (TMFs), however the extent of the use of this approach in veterinary medicine is unknown. The aim of this scoping review was to identify existing veterinary uses of TMFs to inform the uptake of EBPs, and to understand the focus of these applications. Searches were conducted in CAB Abstracts, MEDLINE, Embase and Scopus, alongside grey literature, and ProQuest Dissertations & Theses. The search strategy consisted of a list of known existing TMFs that have been used to improve uptake of EBPs in human health, alongside more generic terminology for implementation and terminology relevant to veterinary medicine. Peer reviewed journal articles and grey literature detailing the use of a TMF to inform uptake of EBP(s) in a veterinary context were included. The search identified 68 studies that met the eligibility criteria. Included studies represented a diverse spread of countries, areas of veterinary concern and EBP. A range of 28 different TMFs were used, although the Theory of Planned Behaviour (TPB) predominated, featuring in 46% of included studies (n = 31). The majority of studies (n = 65, 96%) utilised a TMF with the aim to understand and/or explain what influences implementation outcomes. Only 8 studies (12%) reported the use of a TMF alongside/in conjunction with the actual implementation of an intervention. It is clear there has been some use to date of TMFs to inform uptake of EBPs in veterinary medicine, however it has been sporadic. There has been a heavy reliance on usage of the TPB and other similar classic theories. This has typically been to inform the understanding of factors, such as barriers and facilitators, that may influence the outcome of an implementation effort without then applying this knowledge to the actual implementation of an intervention. Furthermore, there has been a lack of acknowledgement of wider contextual factors and consideration of sustainability of interventions. There is clear potential to increase and expand the usage of TMFs to improve uptake of EBPs in veterinary medicine, including utilising a wider range of TMFs and developing interdisciplinary collaborations with human implementation experts.

Assessment of a joint farmer-veterinarian discussion about biosecurity using novel social interaction analyses.

Veterinarians are trusted by farmers and play an important role in assisting them to implement biosecurity. More research is needed that particularly focuses on the impact of joint farmer-veterinarian discussions to further understand the role of communication in altering biosecurity behaviours. The aim of this study was to analyse joint dairy cattle farmer-veterinarian discussions about the adoption of on-farm biosecurity using novel social interaction methodologies. Farmer and veterinarian stakeholders were invited to take part in a face-to-face meeting. Introductory presentations were given, followed by separate facilitated veterinarian and farmer discussions. All stakeholders were brought together for a final facilitated group discussion which was audio recorded. Corresponding transcripts from the recordings were analysed via thematic and conversation analyses. Conversation analysis assessments such as turn taking, repair, sequence organisation, overlap and asymmetry were employed to investigate the nature of the conversation. Thematic analysis identified the negative repercussions of conflicting information or ineffective communication surrounding biosecurity implementation. The type of, and importance of, the relationship farmers had with veterinarians and other stakeholders was highlighted. The need to provide personalised biosecurity protocols on farms was identified. Four key factors were identified via conversation analyses. These included: 1) how the conversation facilitated agreement, 2) how the conversation allowed the farmer and veterinarian participants to learn from one another in real time, 3) how the discussion enabled participants to expand upon points they were making, and 4) how participants were able to obtain a greater understanding of the other participants' opinions, even without total resolution. Debate around the effective implementation of biosecurity measures on farms, explored using novel techniques, demonstrated the potential for utilising a discussive approach between veterinarians and farmers to lead to solutions not previously considered. Because of the nature of the discussion, conversation analysis resulted in an informative approach to encapsulating the nuanced dialogue between stakeholders, highlighting the potential of this analysis framework.

Levels of Evidence, Quality Assessment, and Risk of Bias: Evaluating the Internal Validity of Primary Research.

Clinical decisions in human and veterinary medicine should be based on the best available evidence. The results of primary research are an important component of that evidence base. Regardless of whether assessing studies for clinical case management, developing clinical practice guidelines, or performing systematic reviews, evidence from primary research should be evaluated for internal validity i.e., whether the results are free from bias (reflect the truth). Three broad approaches to evaluating internal validity are available: evaluating the potential for bias in a body of literature based on the study designs employed (levels of evidence), evaluating whether key study design features associated with the potential for bias were employed (quality assessment), and applying a judgement as to whether design elements of a study were likely to result in biased results given the specific context of the study (risk of bias assessment). The level of evidence framework for assessing internal validity assumes that internal validity can be determined based on the study design alone, and thus makes the strongest assumptions. Risk of bias assessments involve an evaluation of the potential for bias in the context of a specific study, and thus involve the least assumptions about internal validity. Quality assessment sits somewhere between the assumptions of these two. Because risk of bias assessment involves the least assumptions, this approach should be used to assess internal validity where possible. However, risk of bias instruments are not available for all study designs, some clinical questions may be addressed using multiple study designs, and some instruments that include an evaluation of internal validity also include additional components (e.g., evaluation of comprehensiveness of reporting, assessments of feasibility or an evaluation of external validity). Therefore, it may be necessary to embed questions related to risk of bias within existing quality assessment instruments. In this article, we overview the approaches to evaluating internal validity, highlight the current complexities, and propose ideas for approaching assessments of internal validity.

Welfare indicators for stunning versus non-stunning slaughter in sheep and cattle: A scoping review.

BACKGROUND: While most cattle and sheep in the United Kingdom are stunned before slaughter, non-stun methods are permitted to supply meat to specific consumers. This study aimed to identify the existing literature that compared animal welfare indicators during stun and non-stun slaughter, using a scoping review framework. METHOD: Following a structured search strategy, including the establishment of a PICO (population, intervention, comparator and outcomes) question, a comprehensive literature search of the CAB Abstracts, MEDLINE and PubMed databases, was conducted. A total of 962 papers were identified, of which 16 were selected for data extraction. RESULTS: Fourteen papers concluded that welfare at slaughter was negatively impacted at non-stun slaughter in comparison to stun slaughter; two papers were inconclusive. Welfare indicators identified included biochemical parameters, brain activity and visual signs of consciousness. Limitations regarding inconsistent restraint method, neck cut position and non-standardised measures of welfare at slaughter are highlighted. CONCLUSIONS: This study provides further evidence that stunning is an effective method to improve the welfare of sheep and cattle at slaughter. Animal welfare advisors, politicians, religious communities and others interested in animal welfare could use the findings to further discuss and establish new dialogues for producing updated guidance on animal welfare at slaughter.

Investigation of humans individual differences as predictors of their animal interaction styles, focused on the domestic cat.

Humans' individual differences including their demographics, personality, attitudes and experiences are often associated with important outcomes for the animals they interact with. This is pertinent to companion animals such as cats and dogs, given their social and emotional importance to humans and degree of integration into human society. However, the mechanistic underpinnings and causal relationships that characterise links between human individual differences and companion animal behaviour and wellbeing are not well understood. In this exploratory investigation, we firstly quantified the underlying structure of, and variation in, human's styles of behaviour during typical human-cat interactions (HCI), focusing on aspects of handling and interaction known to be preferred by cats (i.e. 'best practice'), and their variation. We then explored the potential significance of various human individual differences as predictors of these HCI styles. Seven separate HCI styles were identified via Principal Component Analysis (PCA) from averaged observations for 119 participants, interacting with sociable domestic cats within a rehoming context. Using General Linear Models (GLMs) and an Information Theoretic (IT) approach, we found these HCI PC components were weakly to strongly predicted by factors including cat-ownership history, participant personality (measured via the Big Five Inventory, or BFI), age, work experience with animals and participants' subjective ratings of their cat behaviour knowledge. Paradoxically, greater cat ownership experiences and self-assessed cat knowledge were not positively associated with 'best practice' styles of HCI, but were instead generally predictive of HCI styles known to be less preferred by cats, as was greater participant age and Neuroticism. These findings have important implications regarding the quality of human-companion animal relationships and dyadic compatibility, in addition to the role of educational interventions and their targeting for optimal efficacy. In the context of animal adoption, these results strengthen the (limited) evidence base for decision making associated with cat-adopter screening and matching. In particular, our results suggest that greater cat ownership experiences and self-reports of cat knowledge might not necessarily convey advantages for cats in the context of HCI.

'We're gonna end up scared to do anything': A qualitative exploration of how client complaints are experienced by UK veterinary practitioners.

BACKGROUND: UK veterinary practitioners are reported to be fearful of client complaints, but their experiences have not been formally captured. Understanding how complaints impact veterinary practitioners is key to mitigating detrimental consequences. METHODS: A qualitative exploration of how UK veterinary practitioners experience and respond to adverse events was conducted. Data were collected via focus groups and interviews, which were transcribed and simultaneously analysed. Coding and theme development were inductive rather than restricted by preconceived theories. RESULTS: Twelve focus groups and 15 individual interviews took place. One theme identified focused on the impact of client complaints. Practitioners experienced unintentional distraction and disengagement from clinical work, as well as employing defensive strategies as a direct result of complaints. The vexatious nature of some complainants was highlighted, along with concerns about practice and regulatory complaint management, lack of appropriate support, discriminatory behaviours and the influence of 'trial by media'. CONCLUSIONS: Client complaints present a threat to practitioner mental health and workforce sustainability, as well as having implications for patient safety. Mitigating these effects is a complex and multifaceted undertaking, but fairness, transparency and timeliness of practice and regulatory complaint investigation must be prioritised, along with provision of tailored support for those facing complaints.

Biosecurity and the ornamental fish trade: A stakeholder perspective in England.

The freshwater and marine ornamental fish industry is a primary route of hazard introduction and emergence, including aquatic animal diseases and non-native species. Prevention measures are key to reducing the risk of hazard incursion and establishment, but there is currently little understanding of the biosecurity practices and hazard responses implemented at post-border stages of the ornamental fish supply chain. This study addresses this knowledge gap, using questionnaires to collate information on actual biosecurity behaviours and hazard responses practised by ornamental fish retailers and hobbyist communities in England. Actual behaviours varied considerably within retailers and hobbyists, suggesting that reliance on preventative practices by individuals in the post-border stages of the ornamental fish supply chain is likely to be ineffective in minimizing the risk of hazard incursion and establishment. Resources should be allocated towards improving and enforcing robust pre- and at-border control measures, such as risk-based surveillance of ornamental fish imports at border controls. In addition, these findings should be used to implement targeted awareness-raising campaigns and help create directed training on biosecurity practices for individuals involved in the post-border stages of the ornamental supply chain.

Re-parameterization of a mathematical model of African horse sickness virus using data from a systematic literature search.

African horse sickness (AHS) is a vector-borne disease transmitted by Culicoides spp., endemic to sub-Saharan Africa. There have been many examples of historic and recent outbreaks in the Middle East, Asia and Europe. However, not much is known about infection dynamics and outbreak potential in these naive populations. In order to better inform a previously published ordinary differential equation model, we performed a systematic literature search to identify studies documenting experimental infection of naive (control) equids in vaccination trials. Data on the time until the onset of viraemia, clinical signs and death after experimental infection of a naive equid and duration of viraemia were extracted. The time to viraemia was 4.6 days and the time to clinical signs was 4.9 days, longer than the previously estimated latent period of 3.7 days. The infectious periods of animals that died/were euthanized or survived were found to be 3.9 and 8.7 days, whereas previous estimations were 4.4 and 6 days, respectively. The case fatality was also found to be higher than previous estimations. The updated parameter values (along with other more recently published estimates from literature) resulted in an increase in the number of host deaths, decrease in the duration of the outbreak and greater prevalence in vectors.

Developing consensus for definitions of key veterinary-specific quality improvement (QI) terms using an eDelphi-study method.

BACKGROUND: Quality improvement (QI) methods are a continuous process of iterative tests to improve the quality of a service or product. Using common language has been linked to the successful implementation of QI in human healthcare. This study aimed to assimilate and achieve consensus on veterinary-specific definitions for terms associated with quality care and QI methods in UK veterinary practice. METHODS: A four-round modified eDelphi process with a panel of 50 UK veterinary practice stakeholders was used to generate consensus. The panel selected or suggested the definition they best felt 'fitted' each term. Consensus was reached if there was >70% agreement, and terms were eliminated if there was <15% selection. RESULTS: Thirty-one panellists completed all three rounds of eDelphi; eight participants completed an optional feedback round. From 14 terms, 10 reached consensus, leaving four unresolved definitions. CONCLUSIONS: A majority of terms reached consensus; 90% were new or amended definitions proposed by panel members. Utilising plain English refined by stakeholders will allow successful implementation of QI in veterinary healthcare. Not all terms achieved consensus, highlighting a need for further research to enable successful integration of QI principles as seen in human healthcare.

Stakeholder Perceptions of Disease Management for Dairy Calves: "It's Just Little Things That Make Such a Big Difference".

Calf morbidity and mortality rates are often high in dairy herds, raising animal welfare concerns and negatively affecting farm economic efficiency and future performance. Disease prevention is critical to maintain calves in good health, but interventions are dependent upon the persons conducting them. This paper explores the perceptions of farmers, farm workers, veterinarians, and other advisors on the management of calfhood disease on dairy farms in England. Participants were recruited using purposive and "snowball" sampling, resulting in 40 in-depth, semi-structured interviews-26 with dairy farmers and 14 with advisors. Interviews were recorded, transcribed, and thematically coded. Three major themes were derived on the basis of interview data: disease occurrence and treatments, management of calf environment, and the role of stockmanship and perceived control. Respiratory and gastrointestinal diseases in calves were those reported to be most problematic on dairy farms. Limited time and financial resources caused some farmers and advisors to experience a perceived inability to control calf health without antimicrobial treatments. Overall, the findings emphasise the importance of human influences on calf health and disease in the context of influencing the interactions among the host, pathogens, and the environment. Further research should investigate what "attention to detail" means within different farm contexts and practices, as this was believed to be important in the promotion of better husbandry standards and health. We recommend the use of supportive knowledge exchange processes, including facilitation, to empower farmers to promote continuous improvement in calf health.