Evidence-Based Healthcare: The Importance of Effective Interprofessional Working for High Quality Veterinary Services, a UK Example

<p class="AbstractSummary"><strong>Objective: </strong></p><p class="AbstractSummary">To highlight the importance of evidence-based research, not only for the consideration of clinical diseases and individual patient treatment, but also for investigating complex healthcare systems, as demonstrated through a focus on veterinary interprofessional working.</p><p class="AbstractSummary"><strong>Background:</strong></p><p class="AbstractSummary">Evidence-Based Veterinary Medicine (EBVM) was developed due to concerns over inconsistent approaches to therapy being delivered by individuals. However, a focus purely on diagnosis and treatment will miss other potential causes of substandard care including the holistic system. Veterinary services are provided by interprofessional teams; research on these teams is growing.</p><p class="AbstractSummary"><strong>Evidentiary value:</strong></p><p class="AbstractSummary">This paper outlines results from four articles, written by the current authors, which are unique in their focus on interprofessional practice teams in the UK. Through mixed methods, the articles demonstrate an evidence base of the effects of interprofessional working on the quality of service delivery.</p><p class="AbstractSummary"><strong>Results:</strong></p><p class="AbstractSummary">The articles explored demonstrate facilitators and challenges of the practice system on interprofessional working and the outcomes, including errors. The results encourage consideration of interprofessional relationships and activities in veterinary organisations. Interprofessional working is an example of one area which can affect the quality of veterinary services.</p><p class="AbstractSummary"><strong>Conclusion: </strong></p><p class="AbstractSummary">The papers presented on veterinary interprofessional working are an example of the opportunities for future research on various topics within evidence-based healthcare.</p><p class="AbstractSummary"><strong>Application:</strong></p><p class="AbstractSummary">The results are pertinent to members of veterinary teams seeking to improve their service delivery, to educators looking to enhance their students’ understanding of interprofessional working, and to researchers, who will hopefully be encouraged to consider evidence-based healthcare more holistically. </p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /

Errors in Veterinary Practice: Preliminary Lessons for Building Better Veterinary Teams

Case studies in two typical UK veterinary practices were undertaken to explore teamwork, including interprofessional working. Each study involved one week of whole team observation based on practice locations (reception, operating theatre), one week of shadowing six focus individuals (veterinary surgeons, veterinary nurses and administrators) and a final week consisting of semistructured interviews regarding teamwork. Errors emerged as a finding of the study. The definition of errors was inclusive, pertaining to inputs or omitted actions with potential adverse outcomes for patients, clients or the practice. The 40 identified instances could be grouped into clinical errors (dosing/drugs, surgical preparation, lack of follow-up), lost item errors, and most frequently, communication errors (records, procedures, missing face-to-face communication, mistakes within face-to-face communication). The qualitative nature of the study allowed the underlying cause of the errors to be explored. In addition to some individual mistakes, system faults were identified as a major cause of errors. Observed examples and interviews demonstrated several challenges to interprofessional teamworking which may cause errors, including: lack of time, part-time staff leading to frequent handovers, branch differences and individual veterinary surgeon work preferences. Lessons are drawn for building better veterinary teams and implications for Disciplinary Proceedings considered

The winding path to a PhD in veterinary education

Masters and PhD degrees specific to veterinary education are relatively novel, but the number of students in this area is growing. As two current students, Tierney Kinnison and Sylvain Dernat, explain, those undertaking these degrees have vastly different backgrounds and are researching a variety of topics. By sharing the experiences of those involved, they hope to encourage the next generation of veterinary educators to begin their research careers

Comically serious: trauma and shame in coming-of-age graphic narratives

The visually arresting nature of the graphic form has appealed to youth from its international emergence in the early twentieth century. Comics of the past, from Little Nemo to The Yellow Kid, were brief and insubstantial, with “a certain naïve vitality to them, which was an accurate reflection of their age,” (Berger, 19). Graphic novels, however, deviate from these predecessors and are widely read in the current, less innocent age by its arguably less innocent youth. Therefore it is important to examine both the medium and messages of the graphic form and how it not only relates to the current young generation, but also how it re-appropriates the age-old trope of the coming-of-age story, a form of literature that has been crucial and mandatory reading in schools for decades due to the coming-of-age that inevitably follows adolescence. This paper briefly looks at the relevance of women within coming-of-age graphic novels and examines the questionable idea, posed by author Hillary Chute, that some female-authored narratives best convey ideas of trauma and public versus private spheres. It then looks at these issues in relation to a male-authored coming of age graphic narrative and in relation to the trauma of shame, and argues that this story conveys all these elements satisfactorily

The global impact of supersaturation in a coupled chemistry-climate model

International audienceIce supersaturation is important for understanding condensation in the upper troposphere. Many general circulation models however do not permit supersaturation. In this study, a coupled chemistry climate model, the Whole Atmosphere Community Climate Model (WACCM), is modified to include supersaturation for the ice phase. Rather than a study of a detailed parameterization of supersaturation, the study is intended as a sensitivity experiment, to understand the potential impact of supersaturation, and of expected changes to stratospheric water vapor, on climate and chemistry. High clouds decrease and water vapor in the stratosphere increases at a similar rate to the prescribed supersaturation (20% supersaturation increases water vapor by nearly 20%). The stratospheric Brewer-Dobson circulation slows at high southern latitudes, consistent with slight changes in temperature likely induced by changes to cloud radiative forcing. The cloud changes also cause an increase in the seasonal cycle of near tropopause temperatures, increasing them in boreal summer over boreal winter. There are also impacts on chemistry, with small increases in ozone in the tropical lower stratosphere driven by enhanced production. The radiative impact of changing water vapor is dominated by the reduction in cloud forcing associated with fewer clouds (~+0.6 Wm?2) with a small component likely from the radiative effect (greenhouse trapping) of the extra water vapor (~+0.2 Wm?2), consistent with previous work. Representing supersaturation is thus important, and changes to supersaturation resulting from changes in aerosol loading for example, might have a modest impact on global radiative forcing, mostly through changes to clouds. There is no evidence of a strong impact of water vapor on tropical tropopause temperatures