A Statewide Survey to Understand Barriers to Utilization of the Medical Orders for Scope of Treatment Form among Emergency Medical Service Providers.

Background: Advance care planning allows communication of end-of-life goals. The Kentucky medical orders for scope of treatment (MOST) form became a legal medical order in 2015. The Kentucky MOST Coalition formed in 2017 to implement MOST. Objectives: In 2019, Kentucky MOST Coalition members developed a survey to determine emergency medical services (EMS) providers' understanding and barriers to utilization of MOST. Design: The Kentucky Board of EMS e-mailed the survey to its members. The survey was voluntarily completed by EMS providers. The data were analyzed by Kentucky MOST Coalition. Results: A majority of participants had never (72%) encountered a MOST form. In addition, 69% said they had never received MOST training. However, 60% knew that "the MOST form is a physician order and shall be followed in all settings." Conclusions: The majority of the EMS providers knew basic information about MOST. However, accessibility and education were barriers to utilization of MOST. EMS providers need continuing education. Education surrounding MOST can help to ensure a person-centered approach.

Contextualized understandings of dairy farmers' perspectives on antimicrobial use and regulation in Alberta, Canada.

Antimicrobial resistance (AMR) has been largely attributed to antimicrobial use (AMU). To achieve judicious AMU, much research and many policies focus on knowledge translation and behavioral change mechanisms. To address knowledge gaps in contextual drivers of decisions made by dairy farmers concerning AMU, we conducted ethnographic fieldwork to investigate one community's understanding of AMU, AMR, and associated regulations in the dairy industry in Alberta, Canada. This included participation in on-farm activities and observations of relevant interactions on dairy farms in central Alberta for 4 mo. Interviews were conducted with 25 dairy farmers. The interviews were analyzed using thematic analysis and yielded several key findings. Many dairy farmers in this sample: (1) value their autonomy and hope to maintain agency regarding AMU; (2) have shared cultural and immigrant identities which may inform their perspectives of future AMU regulation as it relates to their farming autonomy; (3) feel that certain AMU policies implemented in other contexts would be impractical in Alberta and would constrain their freedom to make what they perceive to be the best animal welfare decisions; (4) believe that their knowledge and experience are undervalued by consumers and policy makers; (5) are concerned that the public does not have a complex understanding of dairy farming and, consequently, worry that AMU policy will be based on misguided consumer concerns; and (6) are variably skeptical of a link between AMU in dairy cattle and AMR in humans due to their strict adherence to milk safety protocols that is driven by their genuine care for the integrity of the product. A better understanding of the sociocultural and political-economic infrastructure that supports such perceptions is warranted and should inform efforts to improve AMU stewardship and future policies regarding AMU.

Actualizing Cultural Humility: An Exploratory Study of Veterinary Students' Participation in a Northern Community Health Rotation.

Rotations in diverse, marginalized communities may offer health care students opportunities to develop cultural humility through different clinical experiences and activities. Through the actualization of cultural humility, veterinarians may offer accessible, affordable, culturally proficient, high-quality care to all their patients with a better understanding of how cultural differences affect the animal patient's health, well-being, and care. The purpose of this study was to explore whether participation in a community rotation in remote northern Indigenous communities promotes cultural humility among final-year veterinary students. Small groups of University of Calgary veterinary students travel annually to the Sahtu Settlement Area of the Northwest Territories, Canada, to participate in the Northern Community Health Rotation (NCHR). During the 4-week rotation, students spend 2.5 weeks providing veterinary services to domestic animals in five communities in the Sahtu. Eleven veterinary students who attended the NCHR between 2015 and 2020 answered exploratory open-ended questions in an online survey. Responses highlight areas of learning that contributed to their development of cultural humility. The rotation appears successful in increasing students' confidence working with people from diverse cultures, offering students opportunities to implement a client-centered approach, and advancing their capacity to recognize and challenge their preconceived biases about Indigenous cultures and animal ownership. These experiences are important to the acquisition of cultural humility for veterinary care providers.

Adherence of those at low risk of disease to public health measures during the COVID-19 pandemic: A qualitative study.

Public health measures (PHMs) proactively and reactively reduce the spread of disease. While these measures target individual behaviour, they require broad adherence to be effective. Consequently, the World Health Organization issued a special appeal to young adults, a known non-adherent population, for increased adherence with COVID-19 guidelines. However, little is known about why these low-risk individuals do or do not adhere to PHMs. This study investigates why young adults in a low-risk setting adhered to PHMs implemented during the COVID-19 pandemic. A qualitative research approach was chosen to gain an in-depth understanding of participants' thoughts and experiences related to PHM adherence. Semi-structured interviews were conducted in April-May 2021 with 30 young adults living in Prince Edward Island (PEI), the province with the lowest COVID-19 case rate in Canada at that time. Thematic analysis was used to create a codebook based on the Theoretical Domains Framework, which was then inductively modified. The analysis identified eight themes that explained the adherence of young adults: (1) clear, purpose-driven adherence rationale, (2) developing trust in the local leadership, (3) adapting to novel measures, (4) manageable disruption, (5) adhering to reduce anxiety, (6) collective duty towards one's community, (7) moral culpability and (8) using caution rather than compliance. Together, these themes demonstrate that young adults adhered to PHMs because of their sense of connection to their community, public health leadership, and concerns over stigma. We further argue that clear guidelines and communication from public health officials during both periods of high and low COVID-19 cases facilitate adherence. These findings are important for mitigating future public health emergencies as they explain why young adults, an important segment of the population whose adherence is critical to the success of PHMs, follow PHMs. Further, these findings can inform public health officials and other stakeholders aiming to develop successful adherence strategies.

Animal Protection, Law Enforcement, and Occupational Health: Qualitative Action Research Highlights the Urgency of Relational Coordination in a Medico-Legal Borderland.

Across Canada and internationally, laws exist to protect animals and to stop them from becoming public nuisances and threats. The work of officers who enforce local bylaws protects both domestic animals and humans. Despite the importance of this work, research in this area is emergent, but growing. We conducted research with officers mandated to enforce legislation involving animals, with a focus on local bylaw enforcement in the province of Alberta, Canada, which includes the city of Calgary. Some experts regard Calgary as a "model city" for inter-agency collaboration. Based on partnerships with front-line officers, managers, and professional associations in a qualitative multiple-case study, this action-research project evolved towards advocacy for occupational health and safety. Participating officers spoke about the societal benefits of their work with pride, and they presented multiple examples to illustrate how local bylaw enforcement contributes to public safety and community wellbeing. Alarmingly, however, these officers consistently reported resource inadequacies, communication and information gaps, and a culture of normalized disrespect. These findings connect to the concept of "medico-legal borderlands," which became central to this study. As this project unfolded, we seized upon opportunities to improve the officers' working conditions, including the potential of relational coordination to promote the best practices.

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.

Producer Perceptions Toward Prevention and Control of Lameness in Dairy Cows in Alberta Canada: A Thematic Analysis.

Lameness in dairy cattle poses both an animal welfare and economic threat to dairy farms. Although the Canadian dairy industry has identified lameness as the most important health issue, lameness prevalence in the province of Alberta has not decreased over the last decade. Factors related to lameness have been reported, but the prevalence remains high. Therefore, this study was conducted to investigate dairy producers' perceptions on lameness and how these perceptions influence lameness prevalence in their cows. Qualitative interviews with open-ended questions were conducted with nine dairy producers in Alberta, Canada presenting farms with a wide variety of lameness prevalence. Thematic analysis of these interviews revealed five major themes, as well as five distinct types of producers regarding their perceptions. All nine producers mentioned similar challenges with lameness prevention and control. Identifying lameness, taking action, delays in achieving success, various approaches to prevention and control strategies, and differences between farms were the challenges encountered. However, producers' attitudes when dealing with these challenges varied. We concluded that understanding producers' perceptions is essential as no "one size fits all", when advising them regarding how to address lameness, as guidance and support will be most successful when it is aligned with their viewpoint.

Communication skills training and assessment of food animal production medicine veterinarians: A component of a voluntary Johne's disease control program.

In food animal production medicine (FAPM), the success of control programs for infectious diseases that have serious animal health and economic consequences frequently rely on the veterinarian's effective communication and producer adherence to veterinary recommendations. However, little research has been conducted on communication skills of practicing FAPM veterinarians. During this study, we developed a communication training workshop intervention to support the Atlantic Johne's Disease Initiative. Seventeen FAPM veterinarians across 10 clinics practicing within Maritime Canada participated in a pre-post intervention study design. Communication skills were evaluated utilizing 3 assessment tools; an objective structured clinical exam (OSCE), standardized client feedback, and an instrument designed for veterinary participants to assess their self-efficacy. Study results showed that before training, communication skills of participating veterinarians had limitations, including skill deficits in communication tasks strongly associated with increased adherence to veterinary recommendations. Based on the 3 assessment tools, communication skills of participating veterinarians improved with the training provided. Significant increases were detected in pre- to postintervention self-efficacy percentage scores, OSCE percentage and global scores from expert raters, and OSCE percentage and global scores from standardized client feedback. These improvements emphasize the importance of communication skills training specific to FAPM.

The use of the roter interaction analysis system in assessing veterinary student clinical communication skills during equine wellness examinations in rural Kentucky, USA: A pilot study.

BACKGROUND: Effective clinical communication can aid veterinarians in building good client relationships, increase adherence to recommendations and, ultimately, improve patient health and welfare. However, available information on veterinary communication in the equine context is limited. The objective of this study was to describe the communication of veterinary students in the equine environment who had previous communication training. Additionally, we assessed the suitability of the Roter Interaction Analysis System (RIAS) for the analysis of audio-video recordings of equine wellness consultations. METHODS: Twenty-seven equine wellness consultations performed by second-year Ross University School of Veterinary Medicine students were recorded in rural Kentucky, United States of America. Recordings were submitted to a professional coder who applied the RIAS to the equine context by expanding or adjusting code definitions. RESULTS: A substantial amount of utterances (i.e. segments of speech) were allocated to core communication skills including building rapport (30%), facilitation and client activation (24%) and education and counselling (23%). There was a large variation in utterances used among consultations of the same veterinary student and students; they did not appear anxious or nervous. CONCLUSIONS: Students made use of core communication skills, indicating that experiences from pre-clinical training could be transferred to equine practice. Furthermore, this study demonstrated that the RIAS could be considered for consecutive studies aiming to provide observational data on clinical communication in the equine context.

What Do Veterinary Students Value about Service Learning? Insights from Subsidized Clinics in an Urban Environment.

To promote accessible veterinary care in the community and to help students refine their communication skills, the University of Calgary, Faculty of Veterinary Medicine (UCVM) partnered with the Calgary Urban Project Society (CUPS), a human services organization, to develop the UCVM-CUPS Pet Health Clinics. These clinics are a service-learning experience where third-year students provide services to those facing barriers to veterinary care in Calgary, Alberta. The clinics are offered at CUPS for 6 weeks at 1 day per week. Each student participates in one 4-hour lab; running two 90-minute appointments. In this mixed-methods article, the question was asked: How does a communication-based veterinary service learning program impact students' perception and knowledge of their skills and their perceived role in community outreach to underserved populations and their animals? All third-year veterinary students (N = 30) participated in the 2018 UCVM-CUPS Pet Health Clinics. Students completed a demographics survey, and a pre- and post-clinic questionnaire. Statistical analysis was used to compare pre- and post-clinic responses, and to determine relationships between questionnaire responses and the demographics survey data. Students were significantly more in agreement with statements that demonstrated confidence in their medical knowledge, technical abilities, and communication skills after participating in the program. There was significantly more disagreement to continue volunteering after graduation, but many planned on providing community outreach. Overall, students felt a strong sense of social responsibility and were motivated to help underserved populations. The findings suggest that communication-based, service-learning experiences are related to greater social awareness and enhance students' clinical skills including communication.

From more-than-human solidarity to multi-species biographical value: insights from a veterinary school about ethical dilemmas in One Health promotion.

This article features a partnership between a veterinary school and a charity that aims to enhance the wellbeing of low-income people. Through this partnership, the charity periodically hosts veterinary clinics for clients and their pets. Even as the veterinarians and veterinary students duly examine people's pets, these pop-up clinics aim to help people and their pets. Hence our analysis revolves around the ethics of 'more-than-human solidarity'. By 'more-than-human solidarity', we mean efforts to help others that either center on or that implicate non-human beings. To delve into the ethical and sociological implications of subsidised veterinary services, and to assist with program planning, we conducted several in-depth interviews with veterinarians. Most substantively, we found that the veterinary school's outreach clinics give rise to multi-species biographical value, which is prized as a pedagogical resource for veterinary students. The veterinarians whom we interviewed felt troubled by the extent to which the pop-up clinics ultimately benefited the veterinary school, but also by the shortage of subsidised veterinary services in the vicinity. Based on these interviews and our own reflections, we invite more scholarship on cultural, economic and political influences that shape the lives of human beings and non-human animals alike.

Comparison of veterinarian and standardized client perceptions of communication during euthanasia discussions.

OBJECTIVE: To describe client and veterinarian perceptions of client-centeredness during euthanasia discussions and assess agreement between measures of these perceptions. DESIGN: Descriptive study. SAMPLE: Stratified random sample of 32 companion animal veterinarians in southern Ontario. PROCEDURES: 2 case scenarios (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to initiate euthanasia discussions were presented by 2 different undisclosed standardized clients (USCs) to study veterinarian communication during clinical visits. At the end of appointments, the USC's identity was disclosed, and questionnaires to measure veterinarian and client perceptions of client-centeredness were completed. Agreement was assessed by statistical methods. RESULTS: Data were analyzed from 60 appointments (30/scenario). Of 10 questions, significant agreement was found between veterinarians and USCs for only 1 (extent to which relevant personal and family issues were discussed; κ = 0.43) for the dog scenario and 3 (extent of discussion of respective roles [κ = 0.43], better preparedness of the USC to make a euthanasia decision [κ = 0.42], and discussion of relevant personal and family issues [κ = 0.25]) for the cat scenario. When the USC and veterinarian disagreed, the veterinarian perceived that the client-centeredness components were addressed more thoroughly than did the USC. CONCLUSIONS AND CLINICAL RELEVANCE: Lack of agreement was found between USC and veterinarian perceptions, with USCs perceiving less client-centeredness in euthanasia discussions. This communication gap suggested the need for training of veterinarians in eliciting client perspectives and assessing lifestyle-social information, including client social support systems.

Factors associated with dairy farmers' satisfaction and preparedness to adopt recommendations after veterinary herd health visits.

Herd health and production consultancy are important aspects of the modern dairy veterinary practice; therefore, veterinary farm visits will likely be more successful if veterinary practitioners communicate effectively and meet farmers' expectations. Objectives were to assess dairy farmers' satisfaction with veterinary advisors and their perceived preparedness to adopt veterinary advice. Furthermore, we assessed whether farmers' satisfaction and preparedness to adopt advice were associated with specific predictor variables; that is, general (demographic) factors of veterinarians or farmers, communication tools used by veterinarians, and veterinarians' affective attributes during the farm visit. Audio-video recordings of 14 dairy veterinarians during 70 herd health and production management farm visits were analyzed using the Roter interaction analysis system. Demographic data, farmers' satisfaction, and farmers' preparedness to adopt advice were obtained by using questionnaires. Overall, farmers were satisfied with their veterinarian's communication during farm visits and 58% of farmers felt "absolutely" prepared to follow veterinary recommendations. Based on multivariable regression analysis, farmers' satisfaction was positively associated with their level of education and the amount of talk the veterinarian dedicated to counseling the farmer. However, satisfaction was negatively association with the ratio between veterinarian talk and farmer talk. In addition to various demographic variables, farmers' preparedness to adopt veterinary advice was positively associated with their satisfaction. Other predictor variables for farmers' preparedness to follow recommendations included increased veterinary counseling and frequent herd data discussions, whereas there was a negative relationship between number of farmer questions and dominance of the veterinarian during the farm visit. Identification of factors influencing farmers' satisfaction and preparedness to adopt advice will make veterinary communication more effective and could inform training of veterinarians in communication.

Clinical communication patterns of veterinary practitioners during dairy herd health and production management farm visits.

Effective communication with clients is an important skill for veterinary practitioners and is linked to clients' satisfaction with the consultancy and adherence to medical advice. Detailed description of veterinary communication styles in companion animal contexts has added to the communication knowledge base and informed veterinary curricula and postgraduate education programs. The objective here was to describe veterinary practitioners' communication patterns during dairy herd health and production management farm visits. Fourteen veterinarians in Alberta and Ontario, Canada, were provided with action cameras (Hero3 black edition; GoPro Inc., San Mateo, CA) and recorded 3 to 7 farm visits each. The resulting 70 audio-video recordings were analyzed using the Roter Interaction Analysis System. Additionally, demographic variables were obtained from study participants to investigate associations of these variables with communication patterns. Intraclass correlation coefficients were calculated for communication units, and multilevel negative binomial regression was used to compare communication patterns between demographic groups. Additionally, the relationship-centeredness of interactions was evaluated and compared between groups using linear regression models. Communication patterns varied considerably among recordings of the same veterinarian interacting with different clients. However, most veterinary talk focused on farmer education, counseling, and building a relationship, whereas especially open-ended questions were rare. When discussion revolved around health issues of an individual animal, veterinarians used less social talk but focused more on biomedical information gathering. Veterinarians' age and sex and the length of the veterinarian-farmer relationship had limited association with communications; however, if the farmer and veterinarian were both male, the conversation was more relationship centered. Communication of veterinarians with previous communication training was very similar to that of those without training. Detailed description of veterinary practitioners' communication patterns on dairy farms will contribute to establishing the importance of communication as a clinical skill and is critical to identifying unique aspects of veterinary on-farm communication.

Pets, Social Participation, and Aging-in-Place: Findings from the Canadian Longitudinal Study on Aging.

ABSTRACTThe objective of this study was to assess whether pet ownership contributes to social participation and life satisfaction for older adults. We used baseline data from the Canadian Longitudinal Study on Aging (CLSA) for this purpose, and logistic regression models to estimate associations between social participation and life satisfaction for pet owners and non-owners. One third of all older adults (≥ 65 years, n = 7,474) in our sample reported pet ownership. Pet owners were less likely than non-pet owners to report life satisfaction and to participate frequently in social, recreational, or cultural activities, but pet owners were no less satisfied than were non-owners with their current levels of social participation. For pet owners experiencing barriers to social participation, pets appeared protective of life satisfaction in some circumstances. Both individual characteristics and structural factors linked to the World Health Organization's age-friendly communities framework were relevant to understanding these findings.

"Pets Negotiable": How Do the Perspectives of Landlords and Property Managers Compare with Those of Younger Tenants with Dogs?

Previous research has shown that housing insecurity contributes to animal relinquishment and that tenants with dogs face disadvantages in the rental market. Still, little is known about how dog owners navigate rental markets, nor how landlords and property managers perceive dogs and other pets. This case study reports on in-depth interviews with younger tenants with dogs and on open-ended survey responses from landlords and property managers. In their housing searches, tenants with dogs reported feeling powerless in negotiations and feeling discriminated against. They described settling for substandard properties, often located in less desirable neighborhoods. Also, some said they felt obliged to stay put in these rentals, given how difficult it had been to find a place that would accommodate their dogs. Meanwhile, landlords and property managers indicated that listings advertised as "pet-friendly" tend to receive more applicants than listings in which pets are prohibited. Suggestions for improvement included meeting pets prior to signing the lease; getting everything in writing; steering clear from furnished units; charging utilities to tenants; and speeding up the pet approval process when dealing with condominium boards. These suggestions offer implications for future research, partnerships, and policy options to improve the prospects of pets and their people in rental housing.

Conversation Analysis of Veterinarians' Proposals for Long-Term Dietary Change in Companion Animal Practice in Ontario, Canada.

Nutritional changes recommended by veterinarians to clients can have a major role in animal-patient health. Although there is literature on best practices that can inform veterinary communication training, little is known specifically about how veterinarians communicate their recommendations to clients in real-life interactions. This study used the qualitative research method of conversation analysis to investigate the form and content of veterinarian-initiated proposals for long-term dietary change in canine and feline patients to further inform veterinary communication training. We analyzed the characteristics and design of veterinarian-initiated proposals for long-term nutritional modification as well as the appointment phases during which they occurred, in a subsample of 42 videotaped segments drawn from 35 companion animal appointments in eastern Ontario, Canada. Analyses indicated that veterinarians initiated proposals at various points during the consultations rather than as a predictable part of treatment planning at the end. While some proposals were worded strongly (e.g., "She should be on…"), most proposals avoided the presumption that dietary change would inevitably occur. Such proposals described dietary items as options (e.g., "There are also special diets…") or used mitigating language (e.g., "you may want to try…"). These findings seem to reflect delicate veterinarian-client dynamics associated with dietary advice-giving in veterinary medicine that can impact adherence and limit shared decision-making. Our analyses offer guidance for communication training in veterinary education related to dietary treatment decision-making.

Action cameras and the Roter interaction analysis system to assess veterinarian-producer interactions in a dairy setting.

Herd health and production management (HH&PM) are critical aspects of production animal veterinary practice; therefore, dairy veterinarians need to effectively deliver these services. However, limited research that can inform veterinary education has been conducted to characterise these farm visits. The aim of the present study was to assess the applicability of action cameras (eg, GoPro cameras) worn by veterinarians to provide on-farm recordings, and the suitability of these recordings for comprehensive communication analyses. Seven veterinarians each recorded three dairy HH&PM visits. Recordings were analysed using the Roter interaction analysis system (RIAS), which has been used to evaluate medical conversations in human and companion animal contexts, and provided insights regarding the importance of effective clinical communication. However, the RIAS has never been used in a production animal environment. Results of this pilot study indicate that on-farm recordings were suitable for RIAS coding. Dairy practitioners use a substantial amount of talk allocated to relationship-building and farmer education but that communication patterns of the same veterinarian vary considerably between farm visits. Consecutive studies using this method will provide observational data for research purposes and promise to aid in the improvement of veterinary education through identification of communication priorities and gaps in dairy advisory discussions.

Feline Obesity in Veterinary Medicine: Insights from a Thematic Analysis of Communication in Practice.

Feline obesity has become a common disease and important animal welfare issue. Little is known about how, or how often, veterinarians and feline-owning clients are addressing obesity during clinical appointments. The purpose of this qualitative study was to characterize verbal and non-verbal communication between veterinarians and clients regarding feline obesity. The sample consisted of video-recordings of 17 veterinarians during 284 actual appointments in companion animal patients in Eastern Ontario. This audio-visual dataset served to identify 123 feline appointments. Of these, only 25 appointments were identified in which 12 veterinarians and their clients spoke about feline obesity. Thematic analysis of the videos and transcripts revealed inconsistencies in the depth of address of feline obesity and its prevention by participating veterinarians. In particular, in-depth nutritional history taking and clear recommendations of management rarely took place. Veterinarians appeared to attempt to strengthen the veterinary-client relationship and cope with ambiguity in their role managing obesity with humor and by speaking directly to their animal patients. Clients also appeared to use humor to deal with discomfort surrounding the topic. Our findings have implications for communication skills training within veterinary curricula and professional development among practicing veterinarians. As obesity is complex and potentially sensitive subject matter, we suggest a need for veterinarians to have further intentionality and training toward in-depth nutritional history gathering and information sharing while navigating obesity management discussions to more completely address client perspective and patient needs.

Invited review: Determinants of farmers' adoption of management-based strategies for infectious disease prevention and control.

The prevention and control of endemic pathogens within and between farms often depends on the adoption of best management practices. However, farmers regularly do not adopt recommended measures or do not enroll in voluntary disease control programs. This indicates that a more comprehensive understanding of the influences and extension tools that affect farmers' management decisions is necessary. Based on a review of relevant published literature, we developed recommendations to support policy-makers, industry representatives, researchers, veterinarians, and other stakeholders when motivating farmers to adopt best management practices, and to facilitate the development and implementation of voluntary prevention and control programs for livestock diseases. Farmers will make management decisions based on their unique circumstances, agricultural contexts, beliefs, and goals. Providing them with rational but universal arguments might not always be sufficient to motivate on-farm change. Implementation of recommended management practices is more likely if farmers acknowledge the existence of a problem and their responsibility to take action. The perceived feasibility and effectiveness of the recommended management strategy and sufficient technical knowledge further increase the likelihood of adequate adoption. Farmers will also weigh the expected advantages of a proposed change against the expected disadvantages, and these considerations often include internal drivers such as pride or the desire to conform with perceived standards. Extension tools and farmers' social referents (e.g., veterinarians, peers) not only provide technical information but also influence these standards. Whereas mass media have the potential to deliver information to a broad audience, more personal approaches such as participatory group learning or individual communication with farm advisors can enable the tailoring of recommendations to farmers' situations. Approaches that appeal to farmers' internal motivators or that unconsciously elicit the desired behavior will increase the success of the intervention. Collaboration among stakeholders, assisted by social scientists and communication specialists, is necessary to provide a context that facilitates on-farm change and transfers consistent messages across extension tools in the most effective way.