Zoonotic Disease Management and Infection Control Practices Among Veterinarians in the United Arab Emirates

This study was conducted to assess zoonotic disease management and infection control practices (ICPs) among veterinarians in the United Arab Emirates (UAE). A questionnaire was developed in SurveyMonkey, an online tool, and was distributed by email during February–May 2020 to 470 veterinarians practicing across the UAE. A total of 110 individuals completed the survey, giving a response rate of 23.4% (110/470). Results indicate that reported hand hygiene, sharps management, barrier or isolation practices, and personal choices for personal protective equipment (PPE) in common practice scenarios varied among practitioners. The majority (>75%) of veterinarians in all practice types reported always washing their hands before eating, drinking, or smoking at work. The survey revealed that 19% and 10% of large and small animal veterinarians indicated they sterilized and reused disposable needles. Veterinarians among all practices indicated high rates (75% to 80%) of recapping needles before disposal. When handling an animal suspected of having a zoonotic disease, most (90%) of small animal veterinarians reported always using practices such as isolating the animal and removing outwear before contact with other animals. However, only half (55%) of the large animal respondents reported always isolating the animal or sterilizing all equipment used on the animal of concern. Fewer than half of the large animal (35%) and mixed practice (44%) veterinarians indicated they would always be limiting human contact with the animal of concern. All of the small animal respondents reported full compliance with PPE while performing surgery and necropsy. Among large animal veterinarians, 44% reported not using respiratory or eye protection when aiding with parturition or handling conception products. Failure to use appropriate PPE when handling blood samples was the second most common noncompliant practice among large animal (39%) veterinarians and mixed practice (41%) respondents. Our study indicates a need for continuous education regarding ICPs in the veterinary community in the UAE. Better awareness of the risk of zoonotic disease exposure and options for managing this risk and liability issues could drive the adoption of infection control practices.

Implementing a Geriatric Fracture Program in a Mixed Practice Environment Reduces Total Cost and Length of Stay

Introduction: Geriatric-orthopaedic co-management models can improve patient outcomes. However, prior reports have been at large academic centers with “closed” systems and an inpatient geriatric service. Here we describe a Geriatric Fracture Program (GFP) in a mixed practice “pluralistic” environment that includes employed academic faculty, private practice physicians, and multiple private hospitalist groups. We hypothesized GFP enrollment would reduce length of stay (LOS), time to surgery (TTS), and total hospital costs compared to non-GFP patients. Materials and Methods: A multidisciplinary team was created around a geriatric Nurse Practitioner (NP) and consulting geriatrician. Standardized geriatric focused training programs and electronic tools were developed based on best practice guidelines. Fracture patients >65 years old were prospectively enrolled from July 2018 – June 2019. A trained biostatistician performed all statistical analyses. A p < 0.05 was considered significant. Results: 564 operative and nonoperative fractures in patients over 65 were prospectively followed with 153 (27%) enrolled in the GFP and 411 (73%) admitted to other hospitalists or their primary care provider (non-GFP). Patients enrolled in the GFP had a significantly shorter median LOS of 4 days, compared to 5 days in non-GFP patients (P < 0.001). There was a strong trend towards a shorter median TTS in the GFP group (21.5 hours v 25 hours, p = 0.066). Mean total costs were significantly lower in the GFP group ($25,323 v $29085, p = 0.022) Discussion: Our data shows that a geriatric-orthopaedic co-management model can be successfully implemented without an inpatient geriatric service, utilizing the pre-existing resources in a complex environment. The program can be expanded to include additional groups to improve care for entire geriatric fracture population with significant anticipated cost savings. Conclusions: With close multidisciplinary team work, a successful geriatric-orthopaedic comanagement model for geriatric fractures can be implemented in even a mixed practice environment without an inpatient geriatrics service.

Roger William Herdman

A charismatic vet with a sense of fun, he was a practical man who spent his working life in mixed practice. Devoted to his family, farming and the veterinary profession, he enhanced many people’s lives.

Brian Geoffrey Orbell

A practitioner who worked in mixed practice in Lutterworth for 30 years.

‘I love vet nursing, although working on an island is one of our biggest challenges’

After meandering through a number of roles, Shona Jack found vet nursing and now enjoys working in mixed practice in Shetland.

Combining Unassisted and Robot-Guided Practice Benefits Motor Learning for a Golf Putting Task

Robotic guidance has been employed with limited effectiveness in neurologically intact and patient populations. For example, our lab has effectively used robotic guidance to acutely improve movement smoothness of a discrete trajectory without influencing movement endpoint distributions. The purpose of the current study was to investigate the efficacy of combining robotic guidance and unassisted trials in the learning of a golf putting task. Participants completed a pre-test, an acquisition phase, and an immediate and delayed (24-hour) post-test. During the pre-test, kinematic data from the putter was converted into highly accurate, consistent, and smooth trajectories delivered by a robot arm. During acquisition, three groups performed putts towards three different targets with robotic guidance on either 0%, 50%, or 100% of acquisition trials. Only the 50% guidance group statistically reduced both the ball endpoint distance and variability between the pre-test and the immediate or 24-hr post-test. The results of the 50% guidance group yielded seminal evidence that combining both unassisted and robotic guidance trials (i.e., mixed practice) could facilitate at least short-term motor learning for a golf putting task. Such work is relevant to incorporating robotic guidance in sport skills and other practical areas (e.g., rehabilitation).

I refuse to yield to my injuries

Julian Earl’s 35-year career was spent in mixed practice until it came to abrupt halt when a cycling accident nearly claimed his life. He didn’t let that stop his success story.

I knew I wanted to focus on farm animals

Oliver Hodgkinson is a partner at mixed practice Trefaldwyn Vets in Montgomery, mid Wales, where he works mainly with cattle and sheep.