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.

Endoscopy Practice Management, Fee Structures, and Marketing.

Although our knowledge and appreciation of endoscopic procedures in exotic pets is extensive, associated management practices, including equipment preferences and fee structures, have rarely been discussed. This short article highlights the results of a small survey of 35 experienced exotic animal endoscopists and details their equipment ownership/preferences and fee structures. The importance of marketing is also emphasized.

Perspectivas sobre salud pública veterinaria, seguridad alimentaria y la iniciativa conjunta "Una Salud" / Perspectives on veterinary public health, food security, and the "One Health" joint initiative

Los médicos veterinarios juegan un papel fundamental en la seguridad alimentaria. De su accionar eficiente y transparente depende la salud de millones de personas, la dinamización de las economías de los países, el desarrollo de una actividad pecuaria sustentable en torno los alimentos de este origen y los distintos sistemas agroproductivos que componen las cadenas de valor; y el acceso a mercados internacionales más rentables. Durante las próximas décadas, el cambio en los patrones nutricionales a nivel global, el aumento poblacional esperado, junto con el incremento de las rutas y los volúmenes comercializables de bienes alimenticios, hacen prever que la demanda de alimentos de origen animal se intensificará de forma constante. Para poder enfrentar con éxito estos retos, la profesión veterinaria deberá establecer marcos conceptuales y metodológicos de los perfiles académicos y profesionales más prácticos y actualizados, enfocando la profesión hacia los distintos campos temáticos que componen la salud pública, a nivel de los cursos de grado y posgrado. Por otra parte, deberá también elaborar alianzas interdisciplinarias como la propuesta bajo el enfoque "Una Salud" de la Organización de las Naciones Unidas para la Agricultura y la Alimentación (FAO), la Organización Mundial de Sanidad Animal (OIE) y la Organización Mundial de la Salud (OMS), para establecer marcos de trabajo conjuntos y políticas públicas más acordes con las realidades internas de los países latinoamericanos mediante el abordaje colaborativo, sostenible e integral de la sanidad animal, la seguridad alimentaria y las políticas sanitarias de salud pública.

Veterinarians play a key role in food security. The health of millions of people, stimulation of national economies, development of sustainable livestock production related to this food source, and the different agricultural production systems that compose value chains, and access to more profitable international markets all depend on their efficient and transparent work. Shifting nutritional patterns globally, along with expected population growth, and the increase in marketable food commodity routes and volumes, forecast that demand for animal source food will steadily intensify over the coming decades. To successfully address these challenges, the veterinary profession should establish more practical and up-to-date conceptual and methodological frameworks for academic and professional profiles, focusing the profession on the different public health subject areas, in undergraduate and graduate courses. Furthermore, interdisciplinary alliances should also be developed-such as the "One Health" approach proposed by the United Nations Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE), and the World Health Organization (WHO)-to establish frameworks for joint work and public policies more in line with the domestic conditions of Latin American countries, using a collaborative, sustainable, and comprehensive approach to animal health, food security, and public health policy.

A reliable, low-cost picture archiving and communications system for small and medium veterinary practices built using open-source technology.

Picture Archiving and Communications Systems (PACS) are the most needed system in a modern hospital. As an integral part of the Digital Imaging and Communications in Medicine (DICOM) standard, they are charged with the responsibility for secure storage and accessibility of the diagnostic imaging data. These machines need to offer high performance, stability, and security while proving reliable and ergonomic in the day-to-day and long-term storage and retrieval of the data they safeguard. This paper reports the experience of the authors in developing and installing a compact and low-cost solution based on open-source technologies in the Veterinary Teaching Hospital for the University of Torino, Italy, during the course of the summer of 2012. The PACS server was built on low-cost x86-based hardware and uses an open source operating system derived from Oracle OpenSolaris (Oracle Corporation, Redwood City, CA, USA) to host the DCM4CHEE PACS DICOM server (DCM4CHEE, http://www.dcm4che.org ). This solution features very high data security and an ergonomic interface to provide easy access to a large amount of imaging data. The system has been in active use for almost 2 years now and has proven to be a scalable, cost-effective solution for practices ranging from small to very large, where the use of different hardware combinations allows scaling to the different deployments, while the use of paravirtualization allows increased security and easy migrations and upgrades.