Coaching and feedback: enhancing communication teaching and learning in veterinary practice settings

Communication is a critical clinical skill closely linked to clinical reasoning, medical problem solving, and significant outcomes of care such as accuracy, efficiency, supportiveness, adherence to treatment plans, and client and veterinarian satisfaction. More than 40 years of research on communication and communication education in human medicine and, more recently, in veterinary medicine provide a substantive rationale for formal communication teaching in veterinary education. As a result, veterinary schools are beginning to invest in communication training. However, if communication training is to result in development of veterinary communication skills to a professional level of competence, there must be follow-through with effective communication modeling and coaching in practice settings. The purpose of this article is to move the communication modeling and coaching done in the "real world" of clinical practice to the next level. The development of skills for communication coaching and feedback is demanding. We begin by comparing communication coaching with what is required for teaching other clinical skills in practice settings. Examining both, what it takes to teach others (whether DVM students or veterinarians in practice for several years) and what it takes to enhance one's own communication skills and capacities, we consider the why, what, and how of communication coaching. We describe the use of teaching instruments to structure this work and give particular attention to how to engage in feedback sessions, since these elements are so critical in communication teaching and learning. We consider the preconditions necessary to initiate and sustain communication skills training in practice, including the need for a safe and supportive environment within which to implement communication coaching and feedback. Finally we discuss the challenges and opportunities unique to coaching and to building and delivering communication skills training in practice settings.     

Potential for control of oxidative injury by administration of antioxidants in veterinary medicine

Cellular metabolism results in the production of reactive oxygen species otherwise known as free radicals. When not kept under control these molecules cause damage to various compartments in cells. These molecules are kept in check with antioxidant compounds that can be endogenous to cells or are present in the diet. When this balance is in the favor of reactive oxygen species then the physiological condition is considered to be in oxidative stress, which can lead to oxidative injury in various tissues. There has been a lot of interest in the effects of free radicals and the various degenerative diseases. This interest has lead to theories such as the free radical theory of aging, which states that aging is the accumulation of damage over time that leads to degenerative diseases. This has lead to a host of interest in the interaction of oxidative damage and certain disease states and how antioxidants may be beneficial in helping to modulate various disease states. In order to understand the potential for controlling oxidative injury in veterinary medicine, one needs to understand the cellular processes that reactive oxygen species and antioxidant compounds play in the body. It is usually thought that oxidative injury results in oxidative damage to the lipid, protein, and DNA components of cells. This damage results in alterations in cellular function. Various antioxidant compounds function to scavenge free radicals before they are able to damage the various cellular components     

反刍动物后肠道对碳水化合物的消化吸收研究进展

本文就反刍动物后肠道的容积、食糜存留时间、微生物、淀粉及纤维物质的消化能力及影响因素、VFA的产生与吸收以及后肠道对碳水化合物消化能力与利用等方面进行了综述。后肠道的内容物相当于瘤胃的 15 %～2 6 % ,大肠食糜存留时间为 10～ 2 9h ,5 %～ 30 %的纤维素和 30 %～ 4 0 %半纤维素在大肠消化 ,产生的VFA相当于总产量的 8%～ 17% ,提供相当于进食量 8.6 %的代谢能 ,满足机体 5 %～ 13%的葡萄糖需要。     

Tracheal Endoscopic and Cytological Findings and Blood Examination Results in Thoroughbred Racehorses Suspected to have Lower Respiratory Tract Disease

Cytology of tracheal aspirates, tracheal endoscopic and blood tests were carried out to 86 Thoroughbred racehorses presenting coughs or poor performance which were suspected to have lower respiratory tract disease (LRTD) to assess the conditions of the disorders. Racehorses were classified into coughing (66 horses) and non-coughing (20 horses) groups based on clinical symptoms. Nine Thoroughbred racehorses without respiratory abnormality were used as controls. Assessment of grades of airway mucus, cytology of tracheal aspirates and serum amyloid A (SAA), fibrinogen (Fbg) and pulmonary surfactant protein D (SP-D) measurements were performed. Relationships between age, gender and racing careers were also investigated to understand the characteristics of LRTD in racehorses. Mean age was significantly higher in non-coughing group compared to coughing group. Existence of racing career and number of starts were significantly greater in non-coughing group compared to coughing group. On the other hand, grades of airway mucus were significantly higher in coughing group compared to control group. Percentages of neutrophils in tracheal aspirates were significantly higher in coughing group compared to non-coughing and control groups. SAA, Fbg and SP-D were higher in coughing group compared to non-coughing and control groups indicating that condition of coughing group is in the acute phase. Positive rate of inflammatory airway disease was significantly higher in coughing and non-coughing groups compared to control group. It was concluded that carrying out comprehensive evaluation including investigation on SAA, Fbg and SP-D analysis with airway assessment to Thoroughbred racehorses which were suspected to have LRTD are useful procedure to understand the pathological condition which aid to initiate appropriate treatment, prognosis judgment or to advise trainers to consider altering training regimen.     

Isoleucine requirements of the chicken: the effect of excess leucine and valine on the response to isoleucine.

1. Three experiments were designed to determine the response of broiler chickens to dietary isoleucine, and to quantify the antagonistic effects of excess leucine and valine on this response. 2. A dilution technique was used to measure the responses in growth rate and food intake to a range of diets differing in their isoleucine concentrations. A summit diet was formulated to contain isoleucine at 1.14 times the requirement and with leucine (1.76 times the requirement) and valine (1.87 times the requirement) at the minimum possible concentrations, given the ingredients available. A dilution mixture, devoid of protein, was formulated to correspond in all respects, other than in amino acid content, to the summit diet. These two basal diets were blended in different proportions to give a range of diets of decreasing isoleucine and protein content. 3. In experiment 1 the response was measured to isoleucine with leucine and valine remaining in the same proportion to isoleucine throughout the range of diets fed. In experiments 2 and 3, however, L-leucine and L-valine were added to the diets either singly or in combination to give 6 isoleucine concentrations and 3 ratios of each of leucine and valine to isoleucine. 4. Weight gain decreased as the isoleucine content of the diet was reduced, whereas food intake of broilers fed on the marginally deficient diets increased to a maximum and then decreased. FCE decreased curvilinearly as the isoleucine concentration in the food decreased, reflecting a concomitant change in the fat content of the broilers. 5. It is possible that the amount of dietary isoleucine assumed to be available to the broilers in these experiments was overestimated by hydrolysing the food samples for 72 h, and the doubt thus created makes an estimate of the efficiency of retention of isoleucine suspect. 6. Excess valine had no effect on the response to isoleucine, whereas an increase in the leucine to isoleucine ratio depressed food intake and hence weight gain, but only at the lowest concentrations of isoleucine. 7. If the food content of isoleucine is sufficient to meet the requirements of the broiler, relatively large excesses of leucine, of valine, or of both will not depress growth.     

Orthopedic examination in the cat: clinical tips for ruling in/out common musculoskeletal disease

PATIENT GROUP: The majority of cats will develop radiographic evidence of degenerative joint disease by the time they are 12 years of age, and many will suffer from a decline in quality of life associated with undiagnosed and untreated orthopedic disease. PRACTICAL RELEVANCE: A focused, efficient orthopedic examination, including gait observation and palpation (awake and under sedation), supplemented with appropriate history, is key in ruling in, or out, clinically important musculoskeletal disease. Identifying problems assists in both developing a diagnostic plan and monitoring response to treatment. CLINICAL CHALLENGES: Many clinicians feel uncomfortable in their ability to reliably perform an orthopedic examination in the cat, and diagnosis and evaluation of response to treatment in cats with orthopedic disease can be challenging. Hands-on training in feline orthopedic examination is limited in many veterinary curricula. Additional constraints may include failure to obtain important information in the history that indicates feline orthopedic disease, lack of appropriate facilities in which to conduct a complete orthopedic examination, and inability to obtain the most important information during the time available to conduct the examination. These problems can create gaps in the practitioner's ability to provide excellent care for a large proportion of the feline population. GOALS: The above challenges can mostly be overcome with advanced planning and with consideration of the unique behavioral aspects related to feline handling. As discussed in this review, the aim of the initial orthopedic examination is to localize the problem to a specific limb, ideally to a region or joint of the limb, which can further direct diagnostics such as radiography or arthrocentesis. This should provide a basis for follow-up and assessment of whether treatment strategies are effective.     

Oral and maxillofacial osteosarcoma in dogs: a review

Osteosarcoma in dogs is a heterogeneous disease entity with regard to its histologic, clinical and biologic behaviour. Differences in behaviour are associated with tumour location. Oral and maxillofacial osteosarcomas are typically reported as a component of the broader classifications of axial osteosarcoma or osteosarcoma of flat bones to differentiate them from appendicular osteosarcoma. Similar to human oral and maxillofacial osteosarcoma, in dogs, these also appear to have less aggressive behaviour than appendicular osteosarcoma. Ideally, local control is achieved with wide surgical resection that results in tumour‐free margins. Failure of local control is the most common contributor to poor prognosis. Chemotherapy and radiation treatment are reported to have variable outcomes. The aim of this article is to review the literature on oral and maxillofacial osteosarcoma in dogs in comparison to appendicular and axial osteosarcoma. Similarities and differences between oral and maxillofacial osteosarcoma in humans are addressed.     

Variations in the survival of Fasciola gigantica eggs in bovine dung stored in the sun as opposed to the shade

Eggs of F. gigantica were placed in dung heaps that were located in the shade or exposed to sun light, and examined at intervals for up to 14 weeks. The rate and extent of decline in viability of eggs was greater in dung exposed to sun light than in shaded dung. This difference was attributed the higher temperature in dung in sun light, owing to the effect of direct sunlight and to a higher rate of fermentation in exposed than in shaded dung. It was concluded that strategies for storing dung that would reduce the risk it poses for infecting L. rubiginosa with F. gigantica when used as fertilizer in rice fields include storing dung in sun light rather than in the shade, preferably in a thin layer to allow sunlight to heat and desiccate it, and mixing a carbohydrate with the stored dung to increase heat through fermentation.     

苜蓿的起源与传播考述

苜蓿的起源与传播,既是一个历史问题,也是一个理论问题,不仅是草学界和草史界的重要研究课题,也是农学界乃至农史界的重要研究课题。苜蓿作为一种古老的栽培作物,其起源与传播一直受到人们的关注。伊朗(波斯)为苜蓿的起源中心得到广泛认可。苜蓿有两个不同的起源中心,一是外高加索山区,现代欧洲型苜蓿就来源于此,另一个为中亚细亚,是有史以来的灌溉农业区,夏季酷热干燥,这点和外高加索一样,但不同的是冬季温暖。在伊朗考古遗址中发现的炭化苜蓿种子足以证明苜蓿是一种古老的作物,大约在8000年之前人类就开始利用苜蓿了,在公元前1300年的土耳其和公元前700年的巴比伦人的教科书中就出现了有关苜蓿的记载。像其他作物的传播一样,苜蓿的传播也是通过航海贸易和军队入侵,苜蓿是战马的主要饲料,约在公元前490年,波斯人入侵希腊时,苜蓿种子也随之被带入希腊,苜蓿传入意大利的时间还不确定,可能是公元前200年。在苜蓿传入意大利的同时,公元前126年由汉武帝派往西域的使者张骞将苜蓿种子带入中国。到1550年,苜蓿从西班牙扩展到法国,1565年到比利时和荷兰,1650年到英国,大约在1750年到德国和奥地利,1770年到瑞典,18世纪传到俄罗斯,之后,大约1800年又由欧洲传入新西兰,1806年引入澳大利亚。苜蓿于1535年被传入秘鲁,直到18世纪,苜蓿才被引入阿根廷,从秘鲁又传入智利。苜蓿于1736年,从墨西哥传入美国。     

数种驱虫药和化学药物对体内外鸡蛔虫产卵和虫卵发育的影响

为鉴定男性不育药和有些驱虫药对寄生蠕虫的不育作用,对培养在试管内的鸡蛔虫和卵胚,以及人工感染蛔虫的鸡分别进行了体内和体外试验。棉酚和硝基呋喃类的呋喃唑酮、呋喃西林、S_(73031)和S_(72055)均无抑制产卵和卵胚发育的作用,苯并咪唑类的丙硫咪唑、甲苯咪唑和噻苯咪唑以及吩噻嗪均有抑制产卵和卵胚发育的作用,它们的EMIC_(50)分别为0.006,1.326,0.029和0.052ppm。抑制产卵所需浓度远大于抑制卵胚发育所需浓度。吡喹酮和硫双二氯酚也不具有抑制产卵和卵胚成熟的作用。放线菌酮仅对试管内蛔虫有抑制产卵作用,但对体内蛔虫却无影响。     

Antimicrobial resistance in Salmonella isolated from animals and their environment in England and Wales from 1988 to 1999

Resistance to 16 antimicrobial agents was monitored in 109,125 Salmonella cultures isolated from animals, their environment and feedstuffs between 1988 and 1999. The sensitivity of the 6512 isolates of Salmonella enterica enterica serotype Dublin to all the antimicrobial agents tested varied from 98.2 per cent in 1997 to 99.7 per cent in 1990 and 1996. In contrast, among 28,053 isolates of Salmonella enterica enterica serotype Typhimurium, there was a marked decrease in their sensitivity to all the antimicrobial agents tested, from 57.4 per cent in 1992 to 7.6 per cent in 1995, owing to the widespread occurrence in farm animals of S Typhimurium isolates of the definitive type DT104, resistant to ampicillin, sulphonamides, streptomycin, chloramphenicol and tetracyclines, although the percentage of sensitive isolates increased to 18.4 per cent in 1999, when the incidence of DT104 had decreased. Some isolates of DT104 also showed an increase in resistance to potentiated sulphonamides (2.4 per cent in 1989 to 19.2 per cent in 1999) and nalidixic acid (0 per cent in 1992, 3.8 per cent in 1995 to a peak of 16.9 per cent in 1998). In 1996, 5.1 per cent of 1086 isolates of S Typhimurium from cattle and 35.9 per cent of 192 isolates of S Typhimurium from poultry showed resistance to nalidixic acid. Of the other 74,528 Salmonella isolates, the percentage of strains sensitive to all the antimicrobials tested decreased slightly from 88.2 per cent in 1988 to 70.6 per cent in 1996 and then increased slightly to 73.7 per cent in 1999. The commonest of these other Salmonella serotypes was Salmonella Enteritidis (20,982), which remained predominantly susceptible (ranging from 81.4 to 97.4 per cent) during the study period. Few isolates were resistant to commonly used veterinary antimicrobials, for example, furazolidone, the use of which was banned in 1990, and the aminoglycoside, apramycin.     

Influence of the duration of photoperiod on growth,testicular characteristics and endocrine function of boars

Crossbred boars were used to evaluate the influence of exposure to 8 or 16 hr of light daily from 75 to 175 days of age on growth rate, testicular characteristics and endocrine function. At 160 days of age, concentrations of testosterone in serum (P<.10), the areas under plotted 12 hr testosterone profiles (P<.10) and the number (P<.05) and magnitude (P<.10) of testosterone secretory spikes were increased in boars exposed to 16 hr of light compared to boars in 8 hr light, but concentrations of LH in serum were similar in boars exposed to both treatments. Treatment with GnRH resulted in similar concentrations of LH in serum for both groups of boars. Testosterone in serum after GnRH-mediated LH release was greater at .5 (P<.05) and 1.0 (P<.10) hr following GnRH in boars exposed to 16 hr of light compared to boars at 8 hr, but concentrations of testosterone were similar for both treatments from 1.5 to 4.0 hr after GnRH. Growth rate and testicular and epididymal weights and sperm reserves at 175 days of age were not significantly altered by duration of photoperiod. Boars exposed to 8 hr of light had more hair per unit area than boars exposed to 16 hr of light. We conclude that exposure of prepubertal boars to longer daily photoperiods results in increased concentrations of testosterone in serum at 160 days of age.     

Subchondral cystic lesions of the proximal extremity of the tibia in horses: 12 cases (1983-2000)

OBJECTIVE: To determine clinical and radiographic features of subchondral cystic lesions (SCL) of the proximal extremity of the tibia in horses that could be used to classify these lesions as being related to osteochondrosis or osteoarthritis and to evaluate results of surgical debridement. DESIGN: Retrospective study. ANIMALS: 12 horses with 14 SCL. PROCEDURE: Medical records and radiographs obtained before and after treatment were reviewed. RESULTS: In 6 young horses (8 lesions), SCL were considered to be related to osteochondrosis; all involved the lateral tibial condyle. The remaining 6 horses were mature and had radiographic evidence of osteoarthritis in addition to SCL. Arthroscopic debridement was performed in 4 horses in which lesions were considered to be a result of osteochondrosis and in 3 horses with osteoarthritis. Three horses in which SCL were considered to be a result of osteochondrosis performed athletically after debridement. Two horses with moderate osteoarthritis returned to work after arthroscopic debridement but at a lower level of athletic performance. One horse with SCL related to osteochondrosis responded to medical treatment and went on to race. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that arthroscopic debridement of SCL is feasible in horses in which lesions involve the cranial portion of the lateral or medial tibial condyle, and that treated horses may be able to perform athletically.     

Parasites of domestic and wild animals in South Africa. XLVI. Oestrid fly larvae of sheep, goats, springbok and black wildebeest in the Eastern Cape Province

Merino sheep in Thornveld, Dorper sheep and Angora goats in inland Valley Bushveld, Angora goats and Boer goats in Valley Bushveld on the coastal plateau, and springbok, Antidorcas marsupialis, and black wildebeest, Connochaetes gnou, in Karroid Mountainveld, all in the Eastern Cape Province, were examined for the larvae of nasal bot flies. The sheep and goats were infested with the larvae of Oestrus ovis, and Dorper sheep and Boer goats harboured more larvae than Angora goats on the same farms. Most infestation was present from November to May in Merino sheep in Thornveld, from February to June in Dorper sheep in inland Valley Bushveld, and from May to September in Angora and Boer goats in Valley Bushveld on the coastal plateau. These patterns of seasonality appeared to be regulated by the severity of the summer temperatures at the various localities. The springbok were infested with the larvae of Rhinoestrus antidorcitis, most of which seemed to mature from June to August. All larval sages of Oestrus variolosus and Gedoelstia h?ssleri were present in the black wildebeest, and large numbers of 1st instar larvae of G. h?ssleri appeared to accumulate on the dura of the wildebeest from June to August.     

Proliferative enteropathy: a global enteric disease of pigs caused by Lawsonia intracellularis

Proliferative enteropathy (PE; ileitis) is a common intestinal disease affecting susceptible pigs raised under various management systems around the world. Major developments in the understanding of PE and its causative agent, Lawsonia intracellularis, have occurred that have led to advances in the detection of this disease and methods to control and prevent it. Diagnostic tools that have improved overall detection and early onset of PE in pigs include various serological and molecular-based assays. Histological tests such as immunohistochemistry continue to be the gold standard in confirming Lawsonia-specific lesions in pigs post mortem. Despite extreme difficulties in isolating L. intracellularis, innovations in the cultivation and the development of pure culture challenge models, have opened doors to better characterization of the pathogenesis of PE through in vivo and in vitro L. intracellularis-host interactions. Advancements in molecular research such as the genetic sequencing of the entire Lawsonia genome have provided ways to identify various immunogens, metabolic pathways and methods for understanding the epidemiology of this organism. The determinations of immunological responsiveness in pigs to virulent and attenuated isolates of L. intracellularis and identification of various immunogens have led to progress in vaccine development.     

Quinolone resistance in Escherichia coli.

Escherichia coli is an important pathogen of animals and humans that causes great financial cost in food production by causing disease in food animals. The quinolones are a class of synthetic antimicrobial agents with excellent activity against Escherichia coli and other Gram-negative bacteria used in human and veterinary medicine. Different quinolones are used to treat various conditions in animals in different parts of the world. All members of this class of drug have the same mode of action: inhibition of topoisomerase enzymes, DNA Gyrase and Topoisomerase IV. Escherichia coli can become resistant to quinolones by altering the target enzymes, reducing permeability of the cell to inhibit their entry, or by actively pumping the drug out of the cell. All these resistance mechanisms can play a role in high-level fluoroquinolone resistance, however target site mutations appear to be most important. As all quinolones act in the same way resistance to one member of the class will also confer decreased susceptibility to all members of the family. Quinolone resistant Escherichia coli in animals have increased in numbers after quinolone introduction in a number of different case studies. The resistance mechanisms in these isolates are the same as those in resistant strains found in humans. Care needs to be taken to ensure that quinolones are used sparingly and appropriately as highly resistant strains of Escherichia coli can be selected and may pass into the food chain. As these drugs are of major therapeutic importance in human medicine, this is a public health concern. More information as to the numbers of quinolone resistant Escherichia coli and the relationship between resistance and quinolone use is needed to allow us to make better informed decisions about when and when not to use quinolones in the treatment of animals.     

体外培养对布氏锥虫伊氏亚种药敏性的影响

用小鼠治疗试验和体外药敏试验观察了4个布氏锥虫伊氏亚种虫株在长期体外培养条件下药敏性的稳定性.各虫株的原始群体、连续培养30d和90d的群体对贝尼尔、苏拉灭、安锥赛和硫胂聚氰胺的敏感性基本相同,说明连续培养90d各虫株对上述4种抗锥虫药的敏感性无明显改变.     

Bovine ocular squamous cell carcinoma: superoxide dismutase and catalase levels

Considerable evidence exists for the production of free radicals in the eye region after exposure to ultraviolet light. Failure to remove these radicals adequately may be important in the predisposition of Hereford cattle to ocular carcinoma. The levels of two enzymes, superoxide dismutase and catalase, involved in the removal of superoxide anion and hydrogen peroxide, were compared in Hereford cattle predisposed to ocular carcinoma and a resistant breed, Droughtmaster cattle. The results demonstrate comparable levels of superoxide dismutase in the two breeds in both eye tissue and erythrocytes. Catalase levels also were the same in both breeds. Increased incidence of ocular carcinoma in Herefords does not appear to be due to a deficiency in either superoxide dismutase or catalase.