Application of the multi-theory model to explain veterinarians' intentions to use telehealth/telemedicine

BACKGROUND

Telehealth adoption is being fueled by both technological breakthroughs and societal demands; however, veterinarians have yet to fully embrace the concept of telemedicine, limiting its use and potential benefits. The goal of this study was to evaluate how effective the multi-theory model (MTM) of health behaviour change explains the initiation and sustenance of telehealth use among veterinarians.

METHODS

For this cross-sectional study, a research company was contracted to disseminate the MTM-based online survey to veterinarians currently engaged in clinical practice within the United States.

RESULTS

A total of 243 veterinarians participated in this study. The most frequently reported age group among participants was 31-40 years (33.7%, n = 82). It was also noted that the majority of participants were female (70.0%, n = 170) and white (76.5%, n = 186). Hierarchical multiple regression showed that participatory dialogue (p = 0.037), species (p = 0.013) and previous monthly telehealth use (p = 0.040) were significant explanatory variables of initiation of telehealth use. Moreover, emotional transformation (p < 0.001) and previous monthly telehealth use (p = 0.035) were significant explanatory variables of sustenance of telehealth use.

LIMITATIONS

The data were collected in July 2020, during a global pandemic, in which telehealth use surged across a variety of professions. As a result, the findings of the study may not be relevant in periods when there is no pandemic.

CONCLUSIONS

Based on the findings of this study, researchers, educators and veterinary professionals should consider using MTM as theoretical framework to develop interventions to enhance telehealth use.

Physical Rehabilitation in Zoological Companion Animals

Animal physical rehabilitation is one of the fast-growing fields in veterinary medicine in recent years. It has become increasingly common in small animal practice and will continue to emerge as an essential aspect of veterinary medicine that plays a vital role in the care of animals with physical impairments or disabilities from surgery, injuries, or diseases.1 This is true now more than ever because of the increasing advances in lifesaving treatments, the increased lifespan of companion animals, and the growth of chronic conditions, of which many are associated with movement disorders. The American Association of Rehabilitation Veterinarians (AARV) defines APR as "the diagnosis and management of patients with painful or functionally limiting conditions, particularly those with injury or illness related to the neurologic and musculoskeletal systems." Rehabilitation not only focuses on recovery after surgical procedures but also on improving the function and quality of life in animals suffering from debilitating diseases such as arthritis or neurologic disorders. The overall goal of APR is to decrease pain, reduce edema, promote tissue healing, restore gait and mobility to its prior activity level, regain strength, prevent further injury, and promote optimal quality of life. Typically, a multimodal approach with pharmaceutical and nonpharmaceutical interventions is used by APR therapists to manage patients during their recovery. The purpose of this article aims to provide knowledge and guidance on physical rehabilitation to help veterinarians in the proper return of their patients with ZCA safely after injury and/or surgery.

How can we create a sustainable future for farm animal veterinary practice?

Recruitment and retention is a big problem for the farm vet sector, but it could be overcome by implementing small improvements at all stages of the farm vet pipeline, argues John Remnant.

VetGDP 3: advising for the future

Veterinary Graduate Development Programme (VetGDP) advisers will be central to supporting new graduates as they set, and reach, their professional development goals and settle into life as a veterinary professional. In this article, the third in our series from the RCVS, we hear from three senior vets about their reasons for becoming VetGDP advisers and their experience of the online training they are undertaking.

Expanding the genetic toolbox

Knowledge of canine genetics has advanced rapidly in recent years. Researchers say even deeper understanding is ahead, and that it could support a shift to more preventative veterinary care. But the involvement of a wide group of people will be vital in progressing towards that future.

Moving from vision to reality

The future holds the promise of adding exciting new tools to the veterinary toolbox but,as Claire Read explains, there are still challenges to overcome.

On the threshold of a revolution…

A deeper understanding of the microbiome could help inform individualised treatment for animals and, in the use of faecal microbiota transplantation, a practical application of such knowledge already exists.

A (bio)marker for the future

Centralisation of clinical pathology and with it better biobanking of veterinary samples could speed up the pace of cutting-edge research and its eventual translation into practice.

Herriot is no longer the face of the profession

Vets have traditionally been portrayed in popular culture as white, middle-aged men, but the demographics are changing. By Josh Loeb.

Performance of Veterinary Services Pathway evolution and One Health aspects

Animals, and the health systems which ensure their protection, play a vital role in the security and economic and social well-being of humanity, and are therefore a key component of the One Health concept. For global and national health security, prevention is better than cure, and targeting 'risk at source' in animal populations is a vital strategy in safeguarding the planet from risks of emerging zoonoses and antimicrobial resistance (AMR). Neglected zoonoses - such as rabies and brucellosis - continue to have a significant global impact on human health and are also best managed at their animal source. The World Organisation for Animal Health (OIE) has built international consensus on the principles of good governance and the quality of Veterinary Services, which are incorporated within its international standards. The OIE has a proven track record in the provision of Member Country support based on these standards, especially since the advent of its flagship Performance of Veterinary Services (PVS) Pathway programme in 2006-2007. To date, approximately 140 countries have benefited from the structured and sustainable process of animal health systems evaluation and planning afforded by the PVS Pathway. The PVS Tool, the basic methodology upon which the PVS Pathway is based, addresses One Health by evaluating the Veterinary Authority's ability to coordinate with other Competent Authorities that have a role to play in One Health, most notably public health, food safety, and environmental authorities. Despite the undoubted success of the PVS Pathway, the OIE felt that it was time to consider how the programme might be developed to adapt to new challenges. Consequently, during 2017-2018, the OIE embarked on a process of PVS evolution, during which it carried out extensive consultation and further tailored the PVS Pathway to a changing global context. These improvements, which include both fundamental adaptations to the PVS Pathway methods and the development of new PVS Pathway activities targeting topics such as multisectoral collaboration, rabies and AMR, have further strengthened and embedded the One Health approach within the PVS Pathway.

New approaches for post-vaccination surveillance of foot-and-mouth disease

Foot-and-mouth disease (FMD) is a contagious and important transboundary disease of cloven-hoofed animals and ruminants. In ruminants, an animal is considered as a foot-and-mouth disease virus (FMDV) carrier if a live FMDV/FMDV RNA is obtained from the oro-pharyngeal fluid (OPF) beyond 28 days after infection. These carrier animals may pose a risk for causing outbreaks in healthy animals. Moreover, it is important to conduct serosurveillance to know the virus circulation. In the present study, an ELISA was developed using field samples to detect FMDV specific secretory IgA antibodies. These samples were also tested for the presence of FMDV RNA using quantitative real-time PCR (qRT-PCR). It was found that more carrier animals were detected by IgA ELISA in comparison to qRT-PCR. Thus, IgA ELISA is an important tool to detect FMD carriers. An ELISA based on detection of antibodies against FMDV 2B non-structural protein (NSP) was also used to confirm the results obtained from screening of 3AB3 NSP ELISA. These two new approaches (IgA ELISA and 2B ELISA) form important tools for detection of carriers and virus circulation, respectively, during FMD eradication program. Keywords: foot-and-mouth disease virus; carriers; IgA; 2B non-structural protein; 3AB3 non-structural protein.

Current status of veterinary public health activities in Bangladesh and its future plans

BACKGROUND

Veterinary Public Health (VPH) is a major part of public health in which human health and well-being are the central tasks. In recent years the VPH is gaining increasing importance because immense changes have occurred in animal production processes and agricultural structures. The aim of this paper is to describe the current VPH activities in Bangladesh, its major constraints and future activities plan to ensure safe food production as well as protect the environment and public health.

MAIN TEXT

VPH concerns all areas of food production and safety, zoonosis control, environmental protection and animal welfare. In Bangladesh, the VPH unit was established in 1984 by the Directorate of Livestock Services (DLS) for zoonosis control and production of wholesome food of animal origin. Zoonoses are the core domain of VPH. Bangladesh is facing the emergence of zoonotic diseases including anthrax, tuberculosis, brucellosis, salmonellosis, campylobacteriosis, E. coli infections, avian influenza, rabies, nipah and dengue virus infections.. Multi-drug resistance bacteria are emerging due to indiscriminate uses of antibiotics in livestock and poultry industries. Lack of proper slaughter houses, antemortem and postmortem inspections of carcasses by qualified veterinarians contributes greatly to unwholesome meat production. The VPH unit has a significant role to play to ensure better public health. However, there are many constraints that affect the VPH services. Absence of VPH services at all administrative level, inadequate budget, lack of qualified personnel, poor lab facilities, absence of legal framework, and the lack of coordination with health department are the major constraints.

CONCLUSIONS

The spectrum of VPH issues in Bangladesh is very large. Therefore it is important to carefully set priorities in order to ensure effective and efficient VPH services. Establishment of VPH units at all levels, effective surveillance for zoonotic diseases, institution of legal framework to define role of VPH services, creation of public health awareness, collaborative works with health departments, improving laboratory facilities and training programs for the veterinarian are keys to ensure better VPH services in Bangladesh.

Brain Awareness and Conflict in Veterinary Medical Practice: What Happens and How to Deal with It

Conflict resolution is a technical skill required in medical environments. This article explores interpersonal conflicts through a brain awareness lens and offers tools for increasing the ability to manage conflict in veterinary medical practice.

Canine Cognitive Dysfunction: Pathophysiology, Diagnosis, and Treatment

Canine cognitive dysfunction (CCD) is the canine analog of human Alzheimer disease (AD). The pathophysiology of CCD/AD is multifaceted. CCD is common in aged (>8 years) dogs, affecting between 14% and 35% of the pet dog population. Apparent confusion, anxiety, disturbance of the sleep/wake cycle, and decreased interaction with owners are all common clinical signs of CCD. Although there is no cure for CCD, several proven effective therapeutic approaches are available for improving cognitive ability and maintaining a good quality of life; instituting such therapies early in the disease course is likely to have the greatest positive clinical effect.

Caregiver Burden and Veterinary Client Well-Being

This article describes veterinary client caregiver burden, including how it differs from other key client experiences in the palliative care setting. Caregiver burden in human relationships is reviewed. Research examining veterinary client caregiver burden in the context of serious illness (or pet caregiver burden), including the link between pet caregiver burden and client psychosocial well-being, is summarized. Risk factors for development of pet caregiver burden are discussed in the context of beginning to address how it might be reduced or prevented. Finally, suggestions are provided for veterinarians working with clients facing these issues in a palliative care setting.

Being a breed health coordinator

Liz Branscombe describes what the role is and how it can help improve breed health for pedigree dogs.

[Current concepts and contents of Veterinary Public Health and Veterinary Health Polic]

Human and veterinary medicine obviously share most concepts and contents. However, both academic and scientific issues and the daily practice of many health disciplines can differ largely between human and veterinary medicine. Such differences can easily go unnoticed among other healthcare collectives or the general public. The aim of the present work was to provide an update, as well as some definitions of what we understand under the terms Veterinary Public Health and Veterinary Health Policy.

Craniomaxillofacial Disorders and Solutions in Humans and Animals

Cross-disciplinary collaborations have initiated translational studies in an effort to harness naturally occurring diseases in companion animals to accelerate the development of new treatment modalities, drugs, and device inventions. These synergistic collaborations can identify clinically relevant models that offer the opportunity to conduct rigorous translational investigations. However, the relationship between craniomaxillofacial diseases in companion animals and humans has been widely overlooked. We report here an innovative and visionary 2-d symposium that was organized to gather professionals working on craniomaxillofacial disorders and solutions in humans and/or animals from multiple disciplines, including veterinary physicians, basic scientists, biomedical engineers, physicians, and dentists. The symposium provided a platform for junior and senior investigators and basic science and clinical researchers to network, collaborate, and develop a new clinical and translational framework for accelerated therapy development.

2017: a veterinary year in review

Kathryn Clark takes a look back at some of the significant developments of 2017.

Improving the delivery of veterinary services in Africa: insights from the empirical application of transaction costs theory in Uganda and Kenya

This paper presents a summary of findings from a research project that examined institutional arrangements for providing animal health services in Uganda and Kenya. Given the need to find solutions to the pervasive governance challenges encountered in the delivery of veterinary services in Africa, the study applied transaction economics theory to generate recommendations on how to improve the delivery of these services and minimise livestock production risks, including those that pose a risk to human health, e.g. zoonoses. The most notable recommendations are as follows: i) lower- and middle-income countries should invest in creating an enabling environment that supports the relationship between professional veterinarians and para-professionals, to ensure the timely reporting, treatment and control of animal diseases; ii) the provision of veterinary extension services should not focus solely on household 'heads', but also on other household members, such as wives and children, and on herdsmen; iii) strong government engagement is required in the provision of veterinary services for pastoral or extensive livestock production systems, because normal market forces have failed to attract professional veterinarians and trained para-professionals from the private sector to work in these sectors; iv) farmers must be empowered to hold service providers accountable, by the development and trialling of tools that would enable them to measure the quality of services that they receive and to verify the qualifications of different service providers; v) investment in veterinary education is vital, to ensure that enough qualified veterinary staff are available to offer veterinary services to farmers.

Healthcare Informatics Project-Based Learning: An Example of a Technology Management Graduation Project Focusing on Veterinary Medicine

Teaching Healthcare Informatics using Project-Based Learning focuses students on active and inquiry-based learning and allows them to gain some knowledge and skills in the field. From the perspective of Technology Management, which is at the cross-road of Sciences, Engineering and Business Administration studies, Healthcare Informatics is an interesting application domain for developing both innovation and management capabilities. However, the specificities of Healthcare Informatics (standards, methodologies, human- or animal-focused information) require an additional involvement from the students to deliver projects that fit real-world needs and constraints. In this paper, we initially define the Technology Management field and describe how it is related to Healthcare Informatics, then we introduce Project-Based Learning and finally we present an example of a graduation project that focuses on Veterinary Medicine.

Improving the use of economics in animal health - Challenges in research, policy and education

The way that an economist and an animal health professional use economics differs and creates frustrations. The economist is in search of optimizing resource allocation in the management of animal health and disease problems with metrics associated with the productivity of key societal resources of labour and capital. The animal health professional have a strong belief that productivity can be improved with the removal of pathogens. These differences restrict how well economics is used in animal health, and the question posed is whether this matters. The paper explores the question by looking at the changing role of animals in society and the associated change of the animal health professional's activities. It then questions if the current allocation of scarce resources for animal health are adequately allocated for societies and whether currently available data are sufficient for good allocation. A rapid review of the data on disease impacts - production losses and costs of human reaction - indicate that the data are sparse collected in different times and geographical regions. This limits what can be understood on the productivity of the economic resources used for animal health and this needs to be addressed with more systematic collection of data on disease losses and costs of animal health systems. Ideally such a process should learn lessons from the way that human health has made estimates of the burden of diseases and their capture of data on the costs of human health systems. Once available data on the global burden of animal diseases and the costs of animal health systems would allow assessments of individual disease management processes and the productivity of wider productivity change. This utopia should be aimed at if animal health is to continue to attract and maintain adequate resources.

Domesticated Animal Biobanking: Land of Opportunity

In the past decade, biobanking has fuelled great scientific advances in the human medical sector. Well-established domesticated animal biobanks and integrated networks likewise harbour immense potential for great scientific advances with broad societal impacts, which are currently not being fully realised. Political and scientific leaders as well as journals and ethics committees should help to ensure that we are well equipped to meet future demands in livestock production, animal models, and veterinary care of companion animals.

Fine-needle aspiration in the diagnosis of equine skin disease and the epidemiology of equine skin cytology submissions in a western Canadian diagnostic laboratory

Fine-needle aspiration (FNA) is commonly used to diagnose skin disease in companion animals, but its use in horses appears to be infrequent. Equine veterinarians in western Canada were surveyed to determine their opinions about FNA and 15 years of diagnostic submissions were used to compare the perceived to actual value of FNA in the diagnosis of skin disease in horses. Practitioners viewed FNA as quick, easy, economical, and minimally invasive. However, most veterinarians rarely chose to use FNA due to a perception that sample quality and diagnostic yield were poor and there was a narrow range of diseases the technique could diagnose. Analysis of the FNA cytology samples from a veterinary diagnostic laboratory showed a wide variety of equine skin disease conditions, but the frequency of non-diagnostic results was significantly higher in equine submissions compared to those from dogs and cats.

Veterinary public health in India: current status and future needs

Veterinary public health (VPH) assumes huge significance in developing countries such as India. However, the implementation of VPH services throughout the country is still in its infancy. From 1970 onwards, many institutes, national and international organisations, professional societies, policies and personalities have contributed towards the development of VPH in India. Nevertheless, there is an urgent need to develop VPH still further as there are many issues, such as high population density, the re-emergence of zoonotic pathogens, environmental pollution and antimicrobial resistance, that require attention. The time has surely come to involve all stakeholders, ranging from primary producers (e.g., farmers) to policy-makers, so as to garner support for the holistic implementation of VPH services in India. To improve VPH activities and services, science-based policies enforced through stringent regulation are required to improve human, animal and environmental health. The emergence of the 'One Health' concept has ushered in new hopes for the resurrection of VPH in India. Applying tools such as the World Organisation for Animal Health (OlE) Day One Competencies and the OlE Tool for the Evaluation of Performance of Veterinary Services (PVS Tool) is essential to improve the quality of national Veterinary Services and to identify gaps and weaknesses in service provision, which can be remedied to comply with the OlE international standards. VPH initiatives started modestly but they continue to grow. The present review is focused on the current status and future needs of VPH in India.