PVS评估与差距分析——现代公共管理理念在兽医体系能力建设中的实践探析

伴随全球化格局下世界政治经济社会自然环境发生的巨变,特别是“同一世界,同一健康”理念影响的深入,兽医工作的复杂程度显著增加。世界动物卫生组织（OIE）开展的兽医体系效能（PVs）评估和差距分析,意在帮助成员提升兽医体系能力,实现保护全球动物卫生、兽医公共卫生、生态环境,保障动物源性食品供给与安全,减少贫困的职责目标。本文通过解析PVS评估和差距分析方法中蕴含的现代公共管理理念、原理和方法,探讨应用时可能出现的干扰因素,提出了我国实行良好兽医管理、完善兽医体系、强健履职能力、保障兽医工作成效全面提升的措施建议。     

The combined master of public health program at Tufts University

The Combined Master of Public Health program at Tufts University unites medical and veterinary medical students in a four-year curriculum that integrates students' clinical studies with simultaneous studies on population health. Thirty years ago, Tufts University adopted a "One Medicine" approach to teaching health professionals. That perspective has been updated as "One Health" and is now being applied in a university environment that emphasizes interdisciplinary education, a global outlook, and civic engagement.     

Zooeyia: an essential component of "One Health"

One Health is dedicated to improving the health of all species through the integration of human and veterinary medicine. To date, initiatives have primarily focussed on controlling zoonoses. This paper discusses zooeyia, the positive benefits to human health from interacting with animals, focussing on the companion animal.     

A new approach to teaching veterinary public health at the Ohio State University

Public-health practitioners with expertise in the area of veterinary public health are expected to understand the prevention and control of zoonotic infectious diseases in both human and animal populations. This focus on multiple species is what makes the veterinary public health (VPH) official unique. The development of a new VPH specialization within the existing Master of Public Health (MPH) degree program at the Ohio State University represents a significant new collaboration between the College of Veterinary Medicine and the College of Public Health. The main objective of the VPH specialization is to educate and train professionals to provide them with the skills, knowledge, and resources necessary to protect and improve human health using a One Medicine approach. The program targets a population of students who will likely enter the professional veterinary medicine curriculum but have one year available to enhance their preparatory training in health sciences before beginning the program. A core series of VPH courses was initiated to complement the existing MPH course requirements. The program has been successful in attracting students from the primary target population, but it has also attracted students wanting the MPH as a terminal degree and veterinarians returning to school to expand their career options.     

The challenges of implementing an integrated One Health surveillance system in Australia

As 75 per cent of emerging infectious diseases are of animal origin, a One Health approach that integrates the health of humans, animals and the environment could provide an earlier opportunity for zoonotic disease detection and prevention. In Australia, human, animal and ecological health are managed by separate sectors with limited communication. This study aims to explore how professionals in these fields perceive a One Health approach to zoonotic disease surveillance, aiming to identify the challenges to the implementation of an integrated system in Australia. Using a qualitative research method, ten semistructured interviews were conducted with academic experts to gain insight into the possibility of developing an integrated surveillance system in Australia. A thematic analysis of the data was undertaken. Findings showed the absence of a clear definition and subsequent vision for the future of One Health act as a barrier to interdisciplinary collaboration, and that siloed approaches by different sectors restrict the ability for professionals to work collaboratively across disciplines. An understanding of disease transmission was considered by participants to be a necessary requirement for a successful One Health approach. Finally, participants considered political will an essential requirement for the integration of surveillance systems. This study demonstrates that for a One Health approach to be implemented in an Australian setting, those working in the fields of human, animal and ecological health must agree on several aspects. The establishment of a formal governance body with representatives from each sector could assist in overcoming long‐standing barriers of privacy and distrust. Further, developing interdisciplinary training in One Health concepts for medical, environmental and veterinary students may encourage cross‐disciplinary collaboration. Finally, demonstrating to policymakers the economic benefit of improved and timely detection of zoonoses may help in facilitating a structured One Health approach to disease surveillance in Australia.     

ACVIM small animal consensus statement on safe use of cytotoxic chemotherapeutics in veterinary practice

The purpose of this report is to offer a consensus opinion of ACVIM oncology diplomates and technicians on the safe use of cytotoxic chemotherapeutics in veterinary practice. The focus is on minimizing harm to the personnel exposed to the drugs: veterinary practitioners, veterinary technicians, veterinary staff, and pet owners. The safety of the patient receiving these drugs is also of paramount importance, but is not addressed in this statement. Much of the information presented is based on national recommendations by Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, United States Pharmacopeia, and other published regulations. These directives reflect an abundance of caution to minimize exposure to medical personnel, but large‐scale studies about the consequences of long‐term occupational exposure are not available in veterinary medicine. Challenges in the delivery of optimal treatment safely and economically to veterinary patients in general practice without access to a veterinary oncologist or other specialist, because of costs or proximity, remain.     

Veterinarians and public practice at the Virginia-Maryland Regional College of Veterinary Medicine: building on a tradition of expertise and partnership

The Virginia-Maryland Regional College of Veterinary Medicine (VMRCVM), a regional veterinary college for Maryland and Virginia, has a long and unique tradition of encouraging careers in public and corporate veterinary medicine. The VMRCVM is home to the Center for Public and Corporate Veterinary Medicine (CPCVM), and each year approximately 10% of the veterinary students choose the public/corporate veterinary medicine track. The faculty of the CPCVM, and their many partners from the veterinary public practice community, teach in the veterinary curriculum and provide opportunities for students locally, nationally, and internationally during summers and the final clinical year. Graduates of the program work for government organizations, including the US Department of Agriculture, the Food and Drug Administration, and the Centers for Disease Control and Prevention, as well as in research, in industry, and for non-governmental organizations. Recent activities include securing opportunities for students, providing career counseling for graduate veterinarians interested in making a career transition, delivering continuing education, and offering a preparatory course for veterinarians sitting the board examination for the American College of Veterinary Preventive Medicine. As the VMRCVM moves forward in recognition of the changing needs of the veterinary profession, it draws on its tradition of partnership and capitalizes on the excellence of its existing program. Future plans for the CPCVM include possible expansion in the fields of public health, public policy, international veterinary medicine, organizational leadership, and the One Health initiative. Quality assurance and evaluation of the program is ongoing, with recognition that novel evaluation approaches will be useful and informative.     

Veterinary public health in a problem-based learning curriculum at the Western University of Health Sciences

As detailed in the Association of Schools of Public Health / Association of American Veterinary Medical Colleges 2007 Joint Symposium on Veterinary Public Health, veterinary public health (VPH) can no longer be viewed as a unique sub-specialty of veterinary medicine. Rather, its practice pervades nearly every aspect of the veterinary profession, regardless of whether the practitioner is engaged in small-animal, large-animal, research, corporate, or military practice. In congruence with the practice of VPH, the teaching of VPH should also pervade nearly every aspect of veterinary education. Accordingly, at Western University of Health Sciences, College of Veterinary Medicine (WU-CVM), public health is not simply taught as an individual course but, rather, is interwoven into almost every aspect of the curriculum, continually emphasizing the relevance of this discipline to the practice of veterinary medicine. This article outlines the teaching philosophy of WU-CVM, provides an overview of the curriculum, and describes the integral nature of public health throughout all four years of the educational program.     

Aspects of future animal health: the Animal Health Foresight Project

Against a background of social, political, and environmental change, the challenge to provide the most appropriate education for future veterinarians is daunting. A consideration of the multiple roles of veterinarians in our future society indicates that a different perspective is essential for progress to be made. One example of an approach to reach such a perspective is the Animal Health Foresight Project, which was jointly sponsored in 2005 by the Canadian Food Inspection Agency and the US Department of Agriculture. A new paradigm emerged from this study. This article explores the conclusions of this project and their potential implications for the future of animal health and for veterinary medical education. Outcomes of the Foresight Project led to the development of a new paradigm. The implications for and the possible influence on future animal health and on veterinary medical education are contemplated.     

Linking veterinary and human public-health education: collaborations at the University Of Tennessee

The increasing demand for veterinarians in public health has created an environment for innovative educational approaches, providing opportunities for veterinary students to gain additional education in public health. At the University of Tennessee, this environment has enabled a collaboration between the College of Veterinary Medicine and the College of Education, Health, and Human Sciences to establish a veterinary concentration in an existing Master of Public Health degree program. The veterinary public-health concentration was approved in 2004. In addition, other courses and initiatives have been developed at the College of Veterinary Medicine, creating stronger collaborations with academic units and public-health professionals.     

Expenditures for veterinary services and other costs of disease and disease prevention in 57 California beef herds in the National Animal Health Monitoring System (1988-1989)

Data on costs associated with episodes of disease and disease prevention, including expenditures for veterinary services, were collected from 57 California beef cow-calf herds during 1988-1989 as part of the National Animal Health Monitoring System. Mean cost associated with episodes of disease was $33.90/cow-year, with $0.78 and $1.37/cow-year being spent for veterinary services and drugs, respectively. The highest cost for veterinary services related to episodes of disease were for dystocia, lameness, and ocular carcinoma. For disease prevention, mean expenditures for veterinary services were $1.67/cow-year, nearly all of which was spent on prevention of reproductive tract conditions. Preventive expenditures for veterinary services related to female infertility (pregnancy examination), vaccination against brucellosis and male infertility (breeding soundness examination) were $0.72, $0.39, and $0.22/cow-year, respectively. Many costs associated with episodes of disease and disease prevention were similar to those reported from Colorado National Animal Health Monitoring System beef herds.     

Ethnobotanical knowledge of pastoral community for treating livestock diseases in Somali regional state,eastern Ethiopia

Tropical Animal Health and Production - Modern livestock health care is still at its lowest stage in Ethiopia and most modern veterinary services like drugs and veterinary professionals are not...     

Readability Evaluations of Veterinary Client Handouts and Implications for Patient Care

Health literacy and readability are important considerations for veterinary medicine, as veterinarians commonly distribute brochures, leaflets and info-graphics to explain health related issues to pet owners. Educational materials that are poorly comprehended by the intended audience could result in negative, unintended consequences. Thus, the National Institutes of Health (NIH) and the American Medical Association (AMA) have recommended readability levels for text on health information be targeted between the fourth and sixth grade levels to accommodate a highly diverse public. In the context of veterinary medicine, an increased awareness among veterinary professionals and educators regarding readability scores and the tools available to generate “easy-to-read” text would likely benefit client adherence with veterinary recommendations, client satisfaction with their veterinarian, and ultimately, pet health.Therefore, the goal of this study was to evaluate the readability levels of a sample of popular client handout materials prepared expressly for veterinarians to download and distribute to their pet-owning clients. Results indicate that 9 of 10 client brochures were written above the recommended sixth grade reading level. Recommendations for improving readability are provided.     

Diagnostic alternatives used by veterinary surgeons for the recording of udder diseases in the Norwegian Health Card System for Cattle

A questionnaire, in which 7 cases of udder disease were described, was distributed to 890 veterinarians in Norway. They were requested to classify the cases according to the diagnostic alternatives listed in the Norwegian Health Card System for Cattle (NHCSC). The NHCSC recordings are used for progeny testing of bulls, for disease monitoring, and for research purposes. The aim of this study was to evaluate the quality of the recordings for udder diseases. The questionnaire was answered by 633 veterinary surgeons. Four cases of clinical mastitis (CM) with abnormal secretion as well as other clinical signs of inflammation were correctly classified as CM by almost 100% of the veterinary surgeons. A cow in the final stage of lactation, showing no clinical signs except for clots in the milk, was considered not to be a clinical case by more than 25% of the veterinary surgeons. A typical case of subclinical mastitis (SM) was reported as SM by 83% of the veterinary surgeons, and as CM by 16%. A subclinical case with a recent history of clots in the secretion was classified as SM by 66% of the veterinary surgeons, but almost 40% either reported CM as their sole diagnosis or considered the case to be CM in combination with SM. Of the clinical cases, those exhibiting marked local signs of inflammation and a systemic reaction were correctly classified as acute clinical mastitis (ACM) by 96%-98% of the veterinary surgeons. In the NHCSC, the diagnostic alternatives for cases of CM are ACM and chronic clinical mastitis (CCM). One case, for which the diagnosis subacute clinical mastitis was appropriate according to standard definitions, was classified as CCM by 66%, and as ACM by 6%. Based on the information given in the questionnaire, the diagnosis for 2 of the clinical cases could have been either ACM or CCM, and for both cases each of these 2 alternatives was reported by more than 43% of the veterinary surgeons. A teat lesion, which was present together with ACM in one cow, was reported by 91% of the veterinary surgeons.     

The impact of AVMA COE's accreditation on veterinary medical education

Point 1: the American Veterinary Medical Association Council on Education's (AVMA COE's) accreditation pro-cess is aimed at minimum training for entry-level veterinarians. This has a two-fold consequence: 1. The opportunity to discover the absolute minimum number of necessary resources is opened. While this is a threat to the standard model of veterinary education, it might have value if it is cost-efficient and students graduate with minimal or no debt. 2. There is no mechanism to measure training,research, or service programs above the minimum or beyond the entry level. Point 2: the implication of the minimum entry-level general standard is also two-fold: 1. We must measure performance above the mini-mum. A separate process is necessary (a) to develop and implement objective metrics and (b) to publicize superior achievement as opposed to minimal performance. 2. We must measure and publicize institutions or programs that advance the field beyond training entry-level veterinarians. Service, research, and training aimed at advancing the field, providing leadership, and improving public health and safety(One Health) require separate measurement and advocacy in order to obtain and justify the necessary resources. I conclude that in the absence of a new process by which to measure excellence, market forces will push the entire profession toward the most cost-effective method of providing minimal training for entry-level veterinarians. But what about the far more expensive goal of providing a global public good of which our profession is so proud?The public health and safety mission of veterinary medi-cine, including the entire One Health initiative, requires separate measurement in order to give objective metrics to the institutions and components of the profession committed to those goals to pursue vigorous advocacy and obtain or retain the necessary resources.     

在“同一个健康”框架下,加强兽医与人医合作,有效监测和应对人畜共患病和新发传染病

新发传染病主要是人畜共患病,是世界经济和公共健康的沉重负担。这就要求加强检测、鉴别和监视传染病的能力方面投入。高致病禽流感H5N1、新甲型流感("猪流感")H1N1、非典型性肺炎、西尼罗河病毒、地方流行性狂犬病、布鲁氏菌病以及发展中国家暴发的其它人畜共患病及近期猪抗甲氧西林金黄色葡萄球菌,是人类、动物及其环境相互作用的典型范例。面临中国动物和人类常见的新发传染病坚持"同一个健康"战略,这就要求业已存在的兽医和人医及公共卫生机构的通力合作。人的疾病控制系统与动物疾病控制系统虽然都已经建立,但人畜共患病的暴发表明兽医机构和人医机构密切合作的重要性。在保证环境健康的同时,通过动物疾病和人类疾病监测系统的密切合作,中国就一定能够控制人畜共患病。以这种方式进行疾病预防、监测与应对,各层面及各动物生产部门间有效的兽医推广是加强和保持健康生态环境中人和动物健康的有效办法。中国还需大量努力才能达到从制度上保证预防和消灭疾病。透明而准确的人与动物疾病监督通常会产生经济且可持续的预防疾病方法。加拿大在兽医、公共健康、食品安全和人畜共患病预防方面所发挥的作用就是与中国农业部合作,促进必要的、可持续的兽医监督网络的建设。     

Veterinary medicine and public health or better: veterinary public health

The development of veterinary medicine and its impact on public health are outlined in this overview. In relation to this, we speak of Veterinary Public Health. In 1865, the liberal J.R. Thorbecke initiated the institution of the later independent 'State Supervisory Public Health Inspectorate' was set up in 1920, as a consequence of the Meat Inspection Act of 1919, and became part of the State Supervisory Service. In 1925 the 'Veterinary Public Health Inspectorate', which was part of the Ministry of Public Health, and the 'Veterinary Service', which was part of the Ministry of Agriculture, formed together a so-called 'Personal Union'. This Union came to an end in 1984. During the nearly 60 years of its existence, and especially after the Second World War, the Union has contributed enormously to public health by controlling zoonoses and decreasing chemical contaminants in foodstuffs. In these achievements it has worked in collaboration with veterinary surgeons, meat inspection services, and research institutes such as the National Institute of Public Health and Environment (RIVM), the Institute for Animal Science and Health (ID-Lelystad), and the Faculty of Veterinary Medicine.     

A new model for companion-animal primary health care education

The majority of graduates from veterinary schools in the United States and Canada join companion-animal practices. In most schools, their clinical learning and client interaction experiences occurred primarily in referral teaching hospitals. These specialty hospitals play an essential role in the veterinary care continuum by providing advanced training, clinically-based research, and sophisticated diagnostics and procedures. However, they are not ideal as the principal setting for preparing veterinarians to bring value to the primary health care practices that they join. A new model for companion-animal primary health care education and service delivery has been developed at the Ontario Veterinary College, University of Guelph. The nine integrated programs, which have defined learning objectives and outcome assessments, include communication, nutrition, rehabilitation, behavior, welfare, One Health (ecosystem approach to health), preventive and general medicine, good citizenship, and research. The learning experience begins with first-year student veterinarians and takes place in a practice setting with paying clients from the community. Significantly, the students are learning in an environment that emphasizes the importance of the client experience, teamwork, and practice management while ensuring quality health care for patients. The future of companion-animal primary health care and the optimal preparation of veterinarians are critical issues for the veterinary colleges and profession. Enhanced research into new models for primary health care education and service delivery is urgently needed.     

Connecting knowledge resources to the veterinary electronic health record: opportunities for learning at point of care

Electronic health records (EHRs) provide clinical learning opportunities through quick and contextual linkage of patient signalment, symptom, and diagnosis data with knowledge resources covering tests, drugs, conditions, procedures, and client instructions. This paper introduces the EHR standards for linkage and the partners-practitioners, content publishers, and software developers-necessary to leverage this possibility in veterinary medicine. The efforts of the American Animal Hospital Association (AAHA) Electronic Health Records Task Force to partner with veterinary practice management systems to improve the use of controlled vocabulary is a first step in the development of standards for sharing knowledge at the point of care. The Veterinary Medical Libraries Section (VMLS) of the Medical Library Association's Task Force on Connecting the Veterinary Health Record to Information Resources compiled a list of resources of potential use at point of care. Resource details were drawn from product Web sites and organized by a metric used to evaluate medical point-of-care resources. Additional information was gathered from questions sent by e-mail and follow-up interviews with two practitioners, a hospital network, two software developers, and three publishers. Veterinarians with electronic records use a variety of information resources that are not linked to their software. Systems lack the infrastructure to use the Infobutton standard that has been gaining popularity in human EHRs. While some veterinary knowledge resources are digital, publisher sites and responses do not indicate a Web-based linkage of veterinary resources with EHRs. In order to facilitate lifelong learning and evidence-based practice, veterinarians and educators of future practitioners must demonstrate to veterinary practice software developers and publishers a clinically-based need to connect knowledge resources to veterinary EHRs.