PetVet December 2021 January 2022 by Barkleigh Productions

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VOL. 4 ED.6 • DECEMBER 21 / JANUARY 22

A PRACTICAL GUIDE FOR PET HEALTH PROFESSIONALS

SETTING YOUR PRACTICE UP FOR A SUCCESSFUL

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Veterinarians Who Find Stress Relief THROUGH dog

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A Practical Guide for Pet Health Professionals

CONTENTS 4 PetVet Advisory Board 5 Veterinarian Life Advice 6 Meet The Veterinarians Who Find Stress Relief Through Dog Agility

setting your practice up for a successful

14 The Important of Communication Education in Veterinary Medicine 18 Pet Owners and Opioid Abuse: A Deadly Combination 20 Workplace Drama or Incivility? 30 Key Decision Framework

By Rebecca Mears, DVM

32 PetVet 10: 10 Things to Do This Month Inquiries info@barkleigh.com (717) 691-3388

dr. timothy bentley

Editorial rebecca@barkleigh.com

RESEARCHER & VETERINARIAN enjoys new challenges

Advertising james@barkleigh.com

By Jen Phillips April

PetVetMag

@PetVet_Magazine

Copyright December 2021. PetVet Magazine is published bimonthly by Barkleigh Productions, Inc, 970 West Trindle Road, Mechanicsburg PA 17055. Postmaster: Send change of address to Pet Vet Magazine c/o Barkleigh Productions, Inc., 970 West Trindle Road, Mechanicsburg PA 17055. No part of this publication may be reproduced without written permission of the publisher. Editorial offices: 970 West Trindle Road, Mechanicsburg PA 17055. (717) 691–3388 FAX (717) 691–3381 Email: info@barkleigh.com

PETVET MAGAZINE

ADVISORY BOARD

Meet our EDITORIAL ADVISORY BOARD!

Courtney A. Campbell DVM, DACVS-SA

PetVet’s advisory board is here to help ensure quality content to motivate & educate Veterinarians and their staff.

Jenifer Chatfield DVM, Dipl. ACZM, Dipl. ACVPM

“My passions ultimately drove me towards becoming a veterinarian, but when I was growing up I briefly flirted with the idea of becoming a magician. As a veterinarian, the ability to save lives, keep animals healthy, and strengthen the human– animal bond makes me realize there’s nothing more magical than that.”

STAFF

Executive Editor Rebecca Shipman

Publisher Barkleigh Productions, Inc.

Art Director Laura Pennington

President Todd Shelly Vice President Gwen Shelly Chief Operations Officer Adam Lohr

“People should be so lucky as to get to be a veterinarian. The broad-based education empowers us to be successful in multiple fields and affords us the opportunity to choose how we spend our professional time.”

Graphic Designer Josiah Malinich Web Master Luke Dumberth Marketing Consultant Alex Hammersla

Julie Legred CVT “I have worked in many areas of veterinary medicine and veterinary technology over the last thirty five years, and it is amazing how far our profession has grown and paved the way for the betterment of animals' lives and happiness, as well as improving public health issues. It is an honor for me to be a part of this advisory board to offer additional education and opportunities to grow in our profession.”

Social Media Coordinator Cassidy Ryman

Lisa Powell DVM, DACVECC “I have had the privilege of working with a variety of animals in my career and my passion has allowed me to be involved in teaching veterinary students, interns, residents and other veterinarians. I continue to enjoy going to work every day to help critically ill dogs and cats, and love the client interactions as well. I am proud to be a part of this advisory board to help teach and spread my love for this profession to others in the veterinary community.”

Kathryn Primm, DVM, CVPM

Director of Marketing & Client Relations James Severs

“Animals mean so much to the human condition. It is my privilege to make lives better every day! I cannot imagine myself in any other career.”

Administrative / Marketing Assistant Karin Grottola

PETVET MAGAZINE

VETERINARIAN LIFE ADVICE

“NOT ENOUGH PEOPLE RECOGNIZE THE BENEFIT OF

SPECIALIZATION.

I KNOW THAT SIGNING UP FOR ANOTHER

IS A

years of intense, difficult training

BUT IT’S A

REWARDING CAREER AND KEEPS IT INTERESTING.”

- Dr. Timothy BENTLEY

PETVET MAGAZINE

Photo by Great Dane Photos

lifestyle

MEET THE Veterinarians Who

Find Stress Relief THROUGH

Photo by Great Dane Photos

eterinarians have recently been in the spotlight in United States Dog Agility Association® (USDAA®) news and social media as the organization thanks professionals for their service during particularly challenging pandemic times. And, veterinarians don’t just treat and care for the canines participating in the sport—many are competitors themselves! In addition, they attest to the value of dog agility as an outlet of stress relief from their daily practice.

What is Dog Agility?

By Betty Weibel 6

Dog agility requires dynamic physical and mental engagement for dogs and humans alike. Guided only by voice and movement cues from their human partners, the canine athletes compete against the clock—flying over hurdles, weaving between poles, racing through tunnels and bounding onto the see-saw. Obstacles are set according to the dog’s height and experience level, allowing dogs of all breeds and sizes to compete. The human partners are critical members of the team, as they train the dogs, learn and memorize PETVET MAGAZINE

courses, strategize to tackle each obstacle and race alongside, guiding the dogs to success. Whether at a local club event, at the Dog Agility World Championships or in their own backyard, the teams have to be prepared to do their best in any environment. Agility benefits are not just for those who compete, however. Recreational agility can also improve one’s health and wellbeing.

meet kathy

Benefits of Dog Agility In a 2018 survey conducted by the United States Dog Agility Association, respondents cited numerous advantages to participating in the sport, including physical and mental exercise, socialization and building relationships, bonding with their dogs, satisfaction of meeting challenges and goals, and stress relief. In addition, the benefits of ongoing interaction with dogs alone are well documented: decreased blood pressure, cholesterol and triglyceride levels, and feelings of loneliness; along with increased opportunities for exercise, outdoor activities and socialization.1 There is no better way to understand how the sport has helped a number of veterinarians relieve job stress and enjoy their own dogs than to hear their stories.

Kathy Wells of Southfield, Michigan is one of the sport’s most accomplished competitors and veterinarians. She works at Wyandotte Animal Hospital in Wyandotte, Michigan and credits agility with helping her find a work-life balance that she said is a “huge challenge” in the veterinary profession. Kathy graduated from Iowa

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State University in 1990 and as a student remembers reading an article in Dog Fancy about the new dog sport, agility. Several years later, a training facility posted an advertisement for an agility open house at the clinic where she was working in Toledo, Ohio. “I had never forgotten the article I had read and couldn’t wait to attend the open house.

My dog, a Husky mix, was a natural, and we were hooked. My life path took a complete turn after that night,” Kathy shares. “I never realized how much I relied on agility to maintain my sanity and help me to be able to handle the strain of this job, until it was absent from my life,” she adds. Kathy currently competes with Fargo, an eight-year-old Border Collie, and together they have earned numerous championships: “He has earned LAA-Diamond and ADCH-Diamond, he’s been on the IFCS World Team since 2018, we won a silver medal in Italy in 2018, and competed in the Netherlands in 2019,” she says. While she’s proud of the agility titles, Kathy keeps it in perspective and appreciates how the sport and her profession complement each other. “I have had the philosophy, when competing, that agility isn’t life or death, unlike many of the decisions I make daily being a vet,” Kathy continues, “so I guess being a veterinarian has helped me with my mental game. I do think that being involved in dog sports has made me a better veterinarian.”

meet jean Jean Lavelly attended Auburn University College of Veterinary Medicine, graduating in 1998, and is now a small animal general practitioner in Murfreesboro, Tennessee where she enjoys building relationships with her clients and their animals. “I most enjoy long-term client relationships with families who’ve come to our practice for years and who

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trust me. The most stressful part for me in my early years was feeling I had to prove myself. With the long-term clients, they know I just want the best for their animals. I also love the variety of issues that I see, so no one day is the same,” Jean shares. Like everyone, Jean’s business surged during the pandemic as more people got new puppies. “Combined with the growing shortage of veterinarians, it has made our jobs much more demanding and stressful, which is also causing some veterinarians and support staff to leave the profession early,” she said. She then explained that her involvement in agility has been a coping mechanism: “I think the most important benefit of agility with my dogs is the unique bond we form through training and competing together,” continues Jean. “Agility is also my main motivation for staying fit which means it’s a driving force to help me stay healthy.” Jean actually considered leaving the sport early in the pandemic after the sudden loss of her six-year-old agility partner, Sprint, to GME (Granulomatous meningoencephalomyelitis). “Losing a dog so young is always traumatic, but the added loss of our working relationship was almost too much for me. I seriously considered quitting during this time, but my agility friends were such an important part of my recovery. I was able to regain my love of the sport. The friendships developed over the years really are an important part of agility for me,” she concludes.

Photo by Sujay Venkat

References:

meet HEATHER Heather Venkat of Surprise, Arizona completed her DVM at the University Of Illinois College Of Veterinary Medicine in 2013. She has been Arizona's State Public Health Veterinarian for four years, tracking and investigating diseases like rabies and plague, while still providing preventive veterinary care to dogs and cats with a mobile veterinary clinic called VIP Petcare. “I love the variety that I get from my job (each week is a new adventure) and being able to help both pets and people,” she shared. Heather is a relative newcomer to dog agility who started taking classes in 2017 with a friend and their rescue dogs. “The bond with my dog, Luna, became even stronger and I saw how much she enjoyed agility, and that's when I got hooked and worked towards starting to compete a year later. Luna is a Border Collie/Australian Cattle Dog mix who was found as a stray in the town of Douglas at the Arizona-Mexico border. She's now almost eight years old so most of our training is for maintenance,” Heather says. Like many of her clients, in 2020 during the COVID-19 pandemic, Heather got a new puppy; a Border Collie/Papillon cross named Lyla who is excelling in agility foundation classes. “I am participating in both live events and USDAA@Home. Arizona trials have been very safe and are organized outdoors while following mask and social distancing recommendations,” she says. Speaking to other pet care

If you are interested in learning more about dog agility or looking for a way to get involved, visit the United States Dog Agility Association at usdaa. com which includes a listing of local clubs and events.

1. How to Stay Healthy Around Pets. CDC. www.cdc.gov/healthypets/keepingpets-and-people-healthy/how.html

professionals, Heather added: “It is important for animal care professionals to create boundaries between work and home. We must advocate for ourselves to find time to do things we enjoy and prevent burnout. I like relaxing activities such as reading and writing, but agility relieves my stress by getting my blood flowing and heart pumping. The exercise that both me and my dogs get from doing agility is a win-win!”

Betty Weibel is a former newspaper reporter and longtime journalist who enjoys writing canine, equine and travel articles. As a nonfiction author, she has penned several books with Arcadia/ History Press. She is a public relations professional by trade and works with the United States Dog Agility Association. She resides in Chagrin Falls, Ohio, and is a graduate of Lake Erie College.

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BEST PRACTICES

setting your practice up for a successful

By Rebecca Mears, DVM

he decision has been made…your practice is switching to a new medical records program or practice information management system (PIMS). This can lead to a lot of questions and anxiety, but with proper planning and a strong team, you can set your practice up for success!

extremely important to your project team, but also to everyone at the clinic. These deadlines can be broken into three main categories: data migration, training and going live. Data migration will begin early and is often best broken into smaller tasks amongst a core group. Work closely with your PIMS support team to determine what information is needed when.

Making the Switch Practices look for new PIMS for many reasons. Jeremy Bennet, Project Manager at eVetPractice, states, “Practices face a lot of challenges, and their new medical record system should be something that removes these challenges and makes their lives easier.” This may include anything from improving clinical workflow to increasing the number of new or returning clients to generating revenue. It’s important to select a PIMS that works well for your clinic. Bennet reminds, “Ease of use has to translate into really easy for the staff to find their way around because turnover is real and any additional stressors lead to more turnover.” Plan for the switch to take at least four weeks if starting from scratch; longer if you’ll be moving data over from an existing system. This timeline allows for data migration, configuration and training. Camille Fulton, with Implementation Special Forces at ezyVet, advises practices to select a project team that will help drive the change: “Regardless of timeframe, we recommend designating a project team within the hospital who are responsible for different deliverables. Dedicating the time to set the software up prior will make the transition easier as well.”

Keys to Success Success during this transition is dependent on two key areas: deadlines and communication. Deadlines will be 10

Training of the entire staff should begin approximately one month prior to going live with your new PIMS. Plan for multiple training events throughout that month to cover all necessary material. Set the critical date of going live. This will be a big day at the practice for both staff and clients. It will be important to schedule appropriately around this event to make the transition as smooth as possible. Everyone at a practice can appreciate the power of clear communication. Once a new PIMS has been selected, this is a great time to announce the upcoming change to everyone during a staff meeting. During this time, show a promotional video that showcases the new features of the system. “When the staff are brought into the change, they will be excited to move forward and make the transition a success. But change is difficult, hence support from management is also key for them to feel encouraged,” says Fulton. Be sure to announce major deadlines that pertain to everyone. This helps staff to appreciate the work that is

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1. Lighten the load during the first week of the new system. This will allow the extra time everyone needs to learn the ropes. 2. Login all employees before going live. 3. Be sure to share all necessary info (For example, initial lags in data migration from the last days on the previous system). 4. Establish one or more primary points of contact who will be the “go-to” people for questions. going into the switch as well as establish an understanding about how long the process will take. The most important deadline for the clinic as a whole is the “go live” date. If any changes to deadlines occur, be sure to let staff know to limit confusion.

Training the Team Following the announcement of the switch and the initial promotional video, there will be a pause before the majority of the staff resume preparing for the new PIMS. If possible during this time, make that video available to staff so they can reference back to it as the deadline approaches. It is recommended to begin training modules about a month prior to going live. Your PIMS support team will be able to help direct this process. Following the modules, create a demo account that staff can use to try out the new system. Create tasks that have to be completed on the demo account that staff will be expected to do right out of the gate. This may include using the calendar, creating an invoice or adding a new patient. Having this familiarity and hands-on 12

experience will be extremely beneficial on launch day. Be sure to set aside time for each staff member to sit down and complete the required training. The day-to-day in a veterinary clinic can be so overwhelming that it is easy to push off training, but that will become a regret on the first day of the new system. Many PIMS will recommend a live training session with one of their trainers about a week before going live. This is a great time to refresh staff on the most important aspects of the new system. Be sure to allow ample time for staff to ask questions during the live training, as this is the best opportunity for them to interact directly with the people that know the new system best. Additional role-specific training may be completed after going live. This will help staff members to really excel in their roles with the new PIMS. There may be functions within the system that aren’t utilized on a day-to-day basis, but will become more important as time passes.

Time to “Go Live” “The first few weeks are going to be challenging to staff as they get familiar with the new system. Setting the expectation with the staff and having resources to help staff will make a big difference,” Bennet advises. It’s important to set your practice up for success during this launch period. Having designated go-to people to help troubleshoot problems will be a huge help. “During the setup you can utilize some of your strongest team members as hospital ‘Super Users,’ as we call them. These are staff members who have had additional training early in the project and will be available as peers to help others with the transition,” says Fulton. It’s often recommended to lighten the schedule during the first few days when going live. This will give your team some much-needed additional time as they adjust to the new workflow. Don’t forget to let your clients know what is going on during this time, too. If your practice utilizes a newsletter, prepare your clients for the switch before it happens. Post signage around the clinic asking clients for patience as the team adjusts to a new system. If there are new features that will benefit your clients, include this information on the signage as well. Last but not least—celebrate with the team! Fulton encourages continuing the good vibes throughout the first week to keep morale high; she suggests giveaways and a positive shout-out board to acknowledge everyone’s hard work. Your clinic may elect to cater lunch that day or host a happy hour after work to reward everyone for a job well done. A change of this magnitude can be a challenge, but with proper planning your practice will be enjoying the benefits of the new PIMS in no time.  Dr. Rebecca Mears works as an equine veterinarian in the Mid-Atlantic region. Her clinical interests include client education, preventative care, and dentistry. Outside of clinical medicine she is passionate about helping veterinarians and vet students to achieve their personal and professional goals through improved financial literacy and wellbeing within the profession. Dr. Mears is a 2020 graduate from University of Georgia and a founding member of the VIN Foundation's Rising Leaders Committee. PETVET MAGAZINE

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THE IMPORTANCE OF

COMMUNICATION EDUCATION IN VETERINARY MEDICINE By Dawn M. Sweet, PhD

t had only been a few days since I adopted Sadie who, with her soulful, inquisitive eyes, already had a piece of my heart. We were in the clinic at the local veterinary school for our post-adoption, post-spay wellness check and for some clarity on why Sadie had been intermittingly coughing up saliva infused little pools of blood. Sadie was a presumptively healthy one-year-old Australian Cattle Dog, and in my “I’ve-seen-enough-episodes-ofGray’s Anatomy-to-know-this-is-not-good” mind, I was worried about what this might signal. When the fourth-year veterinary student assigned to my case stepped into the room, I paced nervously and provided detailed responses to each intake question, showed photos of the blood Sadie coughed up and nervously asked, “Why is Sadie coughing up blood?” Without a reply, the student, who was only in the second week of her very first clinical rotation, squeezed and touched Sadie’s throat and listened to her heart and lungs one more time. I sat down, my leg bouncing anxiously up and down, tapping my hand on my bouncing leg. As the students were instructed to do, she asked my permission to take Sadie to the larger exam room where she could do a more detailed 14

exam under the supervision of her teachers. I consented and nervously asked one more time, “Why is Sadie coughing up blood?” As the student left, with Sadie reluctantly in tow, she said, “Her trachea is not properly aligned.” And with that, she was gone, and I was left alone wondering, “What does that mean? How is it is even possible to have a misaligned trachea?” I absentmindedly stood in the room stroking my own throat, assessing the alignment of my own trachea, wondering if it was properly aligned.

The Veterinary Education Curriculum The demands of a veterinary education program are intense. Students are expected to have in-depth knowledge of multiple species in the areas of anatomy, clinical pathology and diagnostic imaging, as well as competence in a wide range of surgical procedures ranging from the more common spays and neuters to more complicated procedures. And now, per a 2004 criterion added by the American Veterinary Medical Association’s (AVMA) Council on Education (COE), students are now also expected to demonstrate competency in interpersonal communication.

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Given the breadth of the curriculum and external stressors, it is not surprising that veterinary medicine students report high levels of depression, anxiety and stress, surpassing the reported levels of human medical student counterparts. On top of curriculum stressors, veterinary students have to contend with managing debt, a heavy workload and impoverished relationships due to isolation. Given the breadth of the curriculum and external stressors, it is not surprising that veterinary medicine students report high levels of depression, anxiety and stress, surpassing the reported levels of human medical student counterparts. Veterinary medicine programs select the most academically-elite and determined students, most of whom have academic backgrounds in applied sciences, animal science or agriculture, with very few coming from liberal arts or social science backgrounds. Yet now that the AVMA has made communication a core competency, students are faced with one more skill to

master; one that for many is in and of itself a source of stress, anxiety and apprehension: communication.

Implications for Communication Communication is not just about “talking good” and relaying information. Communication is about creating shared meaning, building and maintaining relationships, fostering trust and connecting with others. Experiencing elevated levels of stress or anxiety can disrupt the communication process and exacerbate feelings of communication apprehension, which can lead to impoverished interactions. Communication apprehension is defined as “an individual’s level of fear or anxiety associated with either real or anticipated communication with another person or persons.1” As such, it is a stress response to real or anticipated conversations. It can prompt physiological responses such as increased heart rate, increased perspiration and increased breathing, all of which manifest as visible signs (e.g., face flushing, muscle tension) of our internal distress and emotional arousal. Communication apprehension and its physiological behavioral markers can negatively affect one’s ability to communicate effectively, confidently and clearly with another person. When people experience elevated or clinical levels of stress or anxiety, the interpersonal communication process is disrupted; we are

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not able to fully attend to others because our focus is inward. This makes it difficult to focus on social cues and offer contextual appropriate responses. In professions such as veterinary medicine with heavy interpersonal communication demands, coupled with the inclination to avoid or to limit time, communicating with another person is problematic. This is especially so when attention is split and the primary focus is on making sense of clinical signs and presentation of symptoms. People with high levels of communication apprehension are less likely to be successful in professions that require high levels of communication or interaction. In medicine, positive outcomes are connected to communication. A doctor’s skill in effectively communicating with her/his clients is a critical component of the diagnostic process and treatment efforts. Therefore, effective communication with pet owners is necessary to satisfy clients, build relationships with clients,

yield better clinical outcomes, enhance business and avoid malpractice.

A Natural Reaction When the fourth-year student assigned to my case stepped into the exam room, she was breathing noticeably, smiling nervously and unsure of where to stand. Her facial muscles were tense as she began going through all the items on the intake form. She was recording my responses in between chewing on the top of her pen and tapping it nervously on the exam table. Her face flushing, respiration increasing, hands shaking, she reached for her stethoscope. Her body seemed to tense as she knelt on the floor to start Sadie’s physical exam. As she listened to Sadie’s heart and breathing, her eyes darted around the room. With hands still shaking, she stood on unsteady feet, shifting her weight from leg to leg, unsure of what to do or say next. Her eyes never fully met mine as she asked my permission to take

Sadie to the larger exam area. This student was showing classic signs of stress and communication apprehension. How could I expect her to pick up on my own nervousness when she was in an elevated state herself? I am certain she did not intend to cause me additional concern when she said Sadie’s trachea is misaligned, or that Sadie might have leukemia. She was so focused on mastering the clinical side of veterinary medicine that she failed to attend the interpersonal side of it. This is not the reaction of an inept student. This a reasonable reaction to a stress- and anxiety-producing situation when someone is in an environment where the norm is experiencing elevated levels of stress and anxiety. After only three years of classroom instruction and labs, veterinary students spend their fourth year rotating through different services in their college’s veterinary hospital. Because of the breadth of the veterinary medicine curriculum, most of veterinary students’ training is

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focused on medical content rather than “soft skills” such as communication and positive self-care coping strategies.

Wellbeing in Veterinary Medicine The effects of communication apprehension are not necessarily limited to the interaction itself. Communication apprehension could exacerbate an individual’s anxiety or stress, which in turn could influence wellbeing. The practice of mindfulness has garnered much attention in recent years and is considered an inherent human capacity. Mindfulness training for health professionals and human medical students has been shown to relieve mental distress. Even brief online mindfulness trainings have shown benefits of decreasing stress among medical students. This brings us to the current breadth of the veterinary medicine curriculum. How can already overextended veterinary students add one more thing to their schedules? As a communication scholar and a consumer of veterinary medicine services, I understand and support this 2004 criterion added by AVMA’s Council on Education. But I am also aware of the demands of the veterinary medicine curriculum and the negative downstream effects and costs to wellbeing. So, what can we do to better help veterinary students manage stress and anxiety, and subsequently enhance their interactions with veterinary clients? Communication scholars can work with our colleagues in veterinary medicine to identify creative ways to integrate communication training into the veterinary medicine curriculum. Partnerships with student counseling services and trained colleagues with interest in self-care can also be pursued. There are opportunities for creative collaborations across each campus with a veterinary college. And these collaborations do not necessarily need to come at a cost of the medical training. Medical schools in human medicine have been partnering with colleagues from the social sciences to inform curricular

changes for more than 20 years. The positive effects of these collaborations are well documented. Veterinary schools do not need to shoulder the training of their students on their own. In a profession where the natural instinct is to step in and help, it is now time for communication scholars and colleagues with relevant social science backgrounds to step in and help our colleagues in veterinary medicine. Together, we can do better.

In Conclusion Happily, Sadie’s trachea was not misaligned, nor did she have leukemia. It was determined that Sadie’s throat was mildly irritated from being intubated during her spay a few days earlier. Stress and anxiety can lead to communication apprehension, difficulty reading others’ social cues and not having enough available cognitive resources to shape contextually-appropriate responses. Stress and anxiety can also lead veterinary medical students (or any medical professional) to hear zebras instead of horses when they hear hooves. 

doi:10.3138/jvme.0112-006R 4. Sweet, D. M., Gentile, D., & He, L. (2021). Communication Apprehension and Willingness to Communicate in Veterinary Medicine Students: Implications for Mindfulness and Communication Training. Health Communication, 1-9. 5. UCLA Mindful Awareness Research Center, Los Angeles. https://www.uclahealth. org/marc/ Dawn Sweet earned her PhD in Communication from Rutgers University and is an Assistant Professor in the Psychology and Communication Department at the University of Idaho. Dr. Sweet’s professional expertise is in nonverbal behavior and movement patterns. Her research has been featured on NPR All Things Considered, Buzzfeed, and Salon. She and her cattle dog, Sadie, are active in AKC events such as agility, rally obedience, obedience, and trick dog. When not training, they enjoy exploring local mountain ranges and Sadie enjoys being a “demo dog” in Dr. Sweet’s nonverbal communication class.

References: 1. McCroskey, J. C. (1977). Classroom consequences of communication apprehension. Communication Education, p. 78.

Additional Resources: 1. Phang, C. K., Mukhtar, F., Ibrahim, N., Keng, S. L., & Sidik, S. M. (2015). Effects of a brief mindfulness-based intervention program for stress management among medical students: The Mindful-Gym randomized controlled study. Advances in Health Sciences Education, 20(5), 1115-1134. https://doi:10.1007/s10459-015-9591-3 2. Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of mindfulnessbased stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21(6), 581-599. https:// doi:10.1023/A:1018700829825 3. Siqueira-Drake, A.A., Hafen Jr, M., Rush, B. R., & Reisbig, A. M. (2012). Predictors of anxiety and depression in veterinary medicine students: A four-year cohort examination. Journal of Veterinary Medical Education, 39(4), 322-330. https:// PETVET MAGAZINE

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industry news Federal Regulations The American Veterinary Medical Association (AVMA) has regulations regarding controlled substances that veterinary clinics in eighteen states must follow. The states that participate in prescription drug monitoring programs include:

Pet owners & Opioid abuse

• • • • • • • • •

Alaska Arkansas California Connecticut Colorado Indiana Maine Michigan Nebraska

• • • • • • • • •

New Hampshire New York North Carolina North Dakota Oklahoma South Carolina Tennessee Washington West Virginia

However, some veterinary practices follow more than just federal regulations. Some veterinarians look at the animal patient’s previous medical history to determine if the pet owner may be participating in drug abuse.

Stolen Pain Medications

a deadly combination By Caleb Woods

The Drug Enforcement Administration (DEA) must be notified if prescription medications are stolen from a veterinary clinic, including theft by staff members. Veterinarians who prescribe opioids for pain management may have a safety plan in effect due to opioid incidents that can occur—a person addicted to opioids may go to drastic lengths to obtain the drug.

Safety Concerns For Pets

he opioid crisis is largely due to prescription opioid medications or painkillers. In fact, pet owners have started using their pets as a way to get veterinarians to sign off on an opioid prescription.

Opioid Abuse In Veterinary Medicine The Food and Drug Administration (FDA) clearly states that prescription opioids can potentially cause serious risks for those who abuse them. Some of the pain-reducing medications that have contributed to the opioid epidemic include hydrocodone, fentanyl and tramadol. Those who visit their veterinarian may receive medications like buprenorphine for their pets, which is an opioid approved for cats. Veterinarians prescribing opioids to animals may be taken advantage of by pet owners with opioid use disorder.

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There have been instances where pet owners will purposefully hurt their animal in order to get pain medication from their local veterinarian. As AVMA notes, a woman in Kentucky confessed to cutting her dog with razor blades in order to get prescription painkillers to use for herself. In addition, pet owners who are addicted to opioids may neglect their animal in the following ways: • Forgetting to give their pet food and water. • Forgetting to take the pet outdoors. • Intentionally harming the pet. • Leaving the pet outdoors for too long without water.

• Accidentally leaving their pet in a hot car.

A Veterinarian’s Role Veterinarians play an important role in monitoring opioid use. These professionals may take notice of any signs of animal abuse or neglect and may be one of the first to discover that a person is abusing the prescribed medications. Veterinary practices that prescribe medications likely do not use commercial pharmacies. Because of this, it’s important for veterinarians to do the following: • Stock and manage the opioid inventory, always keeping medications behind locks. • Put accountability measures in place, such as double-checking the inventory count. • Require employees to take training courses to learn more about opioid policies and procedures. • Have a safety plan in place for when potential opioid abusers insist their

animal needs medication. Veterinarians can also watch out for common signs of potential opioid abuse in pet owners, which may include: • Inquiring about specific opioid medications by name. • A new client bringing in a pet with suspicious injuries (raising the alarm that the owner harmed their pet to obtain opioids). • Asking for refills because the medications were lost or stolen. • Continuing to request an opioid prescription for their pet. Veterinarians are urged to contact their local police department if they encounter threatening customers or need assistance.

Warning Signs Of Opioid Abuse While these medications are used to control pain, they are also heavily abused. Knowing the warning signs of opioid misuse can prevent opioid overdose and curb this ongoing public health crisis.

In addition to signs of animal mistreatment or frequent visits to the veterinarian, an opioid abuser may: • Be forgetful and not follow through with plans. • Steal items or money from friends or relatives. • Have poor hygiene. • Develop financial difficulties. • Have frequent flu-like symptoms. If you or a loved one struggles with opioid abuse, call our helpline at 1-800526-5053 to learn about our substance abuse treatment options.  Caleb Woods is a writer for Ark Behavioral Health, which services families across the country for addiction related issues. A graduate from the University of North Alabama, he has degrees in English and Film/Digital Media Production. He is the author of the best-selling book Harnessing Darkness and enjoys reading, traveling, and playing board games.

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team management

WORKplace

drama or Incivility?

o one will argue that working with animals is both a rewarding and challenging career. What you didn’t expect was that your human coworkers would be more challenging than the pets—and that the bad behavior could overwhelm you enough to hate your job. Dealing with uncivil behavior on the job is more than just “drama” between two individuals. Drama is for TV shows; what is happening in the workplace is downright incivility and it impacts the entire team.

Even with all these people involved, incivility may go unnoticed…or rather, uncorrected. Some

By Louise Dunn

people don’t want to complain; they put up with it and go about their day. Others are never identified because they are good actors; they know how to kowtow, or “bootlick,” and put on a good show while reserving their bad behavior for less conspicuous times. There is always the chance that management is oblivious to their surroundings… or that management is the source of the incivility. The best course of action is for the business to put a plan in place so team members know the steps to take and can feel confident in taking those steps to remedy the challenging situation.

The “Face” of Incivility Workplace incivility has many faces, ranging from rude, unprofessional behavior to bullying and illegal behavior. The problem is that a little bit of rudeness can grow into bullying when it is ignored. Along the way, individuals suffer, team performance deteriorates, and even the pets receiving care are at risk of harm. You heard that right: Ignoring uncivil behavior can hurt the very pets placed under your care. So, what does this damaging behavior look like?

The following are examples, ranging from subtle to unfair to outright illegal:1, 2, 3 • Rolling eyes, giving somebody a “dirty look” • “Forgetting” to share credit • Speaking with a condescending tone or using biting, sarcastic comments • Interrupting the person • Withholding important client or patient information

• Sabotaging a project or damaging someone’s reputation • Not answering calls or responding to text messages in a timely manner • Sending nasty or demeaning notes • Talking about someone behind his/her back

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• Making accusations about professional competence • Giving public reprimands • Emotional tirades • Giving the silent treatment • Playing favorites • Enforcing consequences inconsistently • Making jokes that rely on stereotypes • Bullying

attendant asks about medication and diet requirements for a pet and receives the uncivil behavior of rolling eyes and being asked if they are incapable of reading instructions. Communication is shut down, and the kennel attendant is left without answers and will attempt to make a decision that may be incorrect due to a lack of information. Coaching the kennel attendant to deal with that situation properly is as easy as giving them a few communication tools.

Do you remember hearing or seeing any of those behaviors? Any chance you are guilty of some of those behaviors? Incivility can creep into any team, and everyone on the team needs to understand that.

Tools to Combat Incivility The first step in addressing incivility begins when someone is hired. Each team member must accept responsibility for interpersonal relationships with one another. Uncivil behaviors must be clearly defined in the employee handbook; a code of conduct, zero-tolerance policy for intimidating behaviors, nonretaliation clause for reporting uncivil behavior, a standard complaint procedure and consequences. From there, training and

Knowledge is Powerful Incivility should not be ignored and should be part of any annual team training or new-hire training. Being aware of the threat and knowing that the company isn’t afraid to face it as soon as it rears its ugly head will create a culture of open communication. Several different factors cause incivility, including, but not limited to, overloaded work duties, fear of talking to the supervisor, stresses in home and family life, low morale among the team, pay cuts or freezing pay, changing managers and cultural differences. Knowing common precipitating factors will help supervisors and team members to be on the lookout for instances of incivility before it becomes part of the business culture. In addition to knowing the causes and the common signs, it is essential to discuss the impact on pets. A culture of incivility undermines patient safety because it impacts the team’s ability to perform their job. Both the receiver and the perpetrator can create a problem in the delivery of medical care—not that they would do so consciously, but something as “simple” as rolling eyes and refusing to answer someone’s question can hamper that person from doing the job correctly, and the pet may end up suffering. Consider the impact if a kennel PETVET MAGAZINE

coaching become important steps. Supervisors must receive leadership training. The training should include topics such as business policies and procedures, communication styles, conflict and resolution, and common manager errors to avoid. When dealing with an employee’s complaint of uncivil behavior, a supervisor should be educated on common pitfalls he/she must avoid, such as rushing to judgement, choosing sides, dismissing the complaint as silly, making excuses for the perpetrator, joking about it or discussing it with others. An unprepared supervisor is of no help when a conflict situation arises, and his/her reaction (or lack thereof ) leads to continued frequency of uncivil behavior. A well-prepared supervisor can now educate the team. Team-building sessions to build trust, training on recognizing and responding to workplace incivility, and simulation exercises to model positive interactions will go a long way in creating a culture that quickly identifies and mitigates

uncivil behavior among team members. Teach communication skills for different situations by presenting a situation and then discussing potential triggers and potential actions that can be taken. Include in the training the use of “I” statements instead of “You” statements (e.g., I find it very difficult to take care of the kennel when care instructions are confusing, and I worry that the pets will be harmed). Other tools are de-escalation strategies, how to set boundaries, knowing what to do when incivility crosses the line and knowing what help is available. Coaching the team through difficult conversations with each other is no different than coaching them about difficult clients and how to deal with the general public. When the team is regularly provided with the tools to handle those difficult moments of uncivil behavior, relationships can be saved and the team can maintain a positive work environment. Notice the term “regularly;” lack of consistency in training programs and

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supervisor response will only work against the team and the business, therefore, incivility training is not a one-and-done training session and should be part of a regular training rotation. Avoiding the “drama” of incivility at work requires efforts by employees, supervisors and business owners. It requires training on the ability to cope with and respond to workplace incivility effectively. In the end, both the humans and the pets will come out winners.

References: 1. Incivility in the Workplace. Solution Services. https://www.ssihr.com/ incivility-in-the-workplace/ 2. 5 Common Examples of Workplace Incivility: What To Do About Negative Behavior. Eli Inc. https://www.eliinc.com/ five-common-examples-workplace-incivility/ 3. Workplace Incivility on the Rise: Four Ways to Stop It. HR Exchange Network. https://www.hrexchangenetwork.com/ hr-talent-management/articles/workplaceincivility-on-the-rise-four-ways-to-stop Louise Dunn is a renowned award-winning speaker, writer and consultant. She brings over 40 years of inthe-trenches experience and her business education to veterinary management. Louise is founder and CEO of Snowgoose Veterinary Management Consulting. SVMC works with veterinarians who want to develop a strategic plan that consistently produces results. Most recently Louise received many awards including the WVC Educator of the Year numerous times and VetPartner’s The Life Time achievement Award in January 2016. Besides all aspects of practice management and mentoring, Louise’s passions include her husband, Joel, her English mastiff Therapy dog, Zuri, her little sister, Annabelle, as well as kayaking, opera and New England Patriot’s football.

petvet profile

dr. timothy bentley RESEARCHER & VETERINARIAN enjoys new challenges By Jen Phillips April

rom a small farm near Liverpool, England, to a renowned researcher, Dr. Timothy Bentley thrives on better understanding the canine brain. And, as the Director of the Canine Brain Tumor Research Program at Purdue University in Indiana and one of Veterinarianedu.org’s “15 Most Influential Veterinarians,” he’s definitely one to know. Here Dr. Bentley shares his realization that veterinarian specialty was possible and his insight into his current research that can change the course of both canine and human health. However, like many veterinarians, he came into the field thinking of vets as general practitioners. “In my mind, vets were GP’s. They did a few cats and dogs, ducks, cows, and a little bit of everything. My idea of what a veterinarian did was very different. I didn’t realize specialization was an option,” he shares. Dr. Bentley said a course in veterinary school was his “aha” moment: “The lightbulb went off for me

when I took a course on the functioning of the nervous system. It’s usually an unpopular course because it’s hard and very detailed. I was the one person in the class who loved it. Our class instructor mentioned that spinal surgeries and MRIs were becoming routine in veterinary medicine, and I thought that was interesting. It really suits my personality to try and do one thing well rather than try to do a lot of things.” Fast forward 16 years, and that specialization has paid off. As the Director of the Canine Brain Tumor Research Program at Purdue University, he splits his time between the office and the teaching hospital, and always gets to explore new questions around canine health.

A TYPICAL DAY “I have two jobs. In academia, I have ‘off-clinic’ days where I spend a lot of time in my office trying to get grants and funding. I also just finished writing

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“THE MOST REWARDING disc surgery is when the residents do the surgery, and I just watch. It’s rewarding to watch them grow.”

– Dr. Timothy Bentley

a chapter in a textbook. Then, we have typical procedure days and typical appointment days where I’m often overseeing students,” shares Dr. Bentley. He also has appointment days where he’s in the hospital, seeing patients and working with the residents. In the hospital setting, every day is different. “Sometimes there are emergencies who’ve come in overnight and are waiting for us. Sometimes it’s all spinal problems with slipped discs. Sometimes all the cases are medical, and sometimes they’re all surgical,” he adds. “One of the difficult things about neurology is that paralyzed dogs will turn up in the middle of the day on what was planned to be an appointment day. It just comes with the territory,” Dr Bentley

continues. “So we’re forever squeezing things in and staying late. Things like seizures happen when they happen, so it can be very unpredictable.”

WORKING WITH THE VETERINARY STUDENTS “Slipped discs are our bread and butter. The most rewarding disc surgery is when the residents do the surgery, and I just watch. It’s rewarding to watch them grow,” he shares enthusiastically. Dr. Bentley says the residents spend three years in the program training to be board-certified specialists. “We usually have three residents, but right now, we have two residents and one intern. They’ve already done an extra year of training where they’ve done a little of everything.

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Then three years with us training to be a specialist. They’ve all passed their exams,” he adds.

CANINE BRAIN SPECIALIST

CURRENT RESEARCH Research is constantly evolving. Currently, Dr. Bentley is working with the University of Alabama on cancer research. In the study, the researchers have GMO’d the herpes simplex virus to attack cancer cells. As viruses go, the herpes simplex virus is pretty harmless, only causing cold sores. Dr. Bentley says, “At Alabama, they’ve removed part of the genetic code of the virus so it only interacts with cancer cells and it’s injected into the brain.” That work was met with success and has FDA approval, which led to the question of, “Can we use higher doses, and will that make the patient infectious?” “Now we’re in the closing stages of that study, and none of the patients have become contagious, and none of the dogs have developed any side effects from the virus,” he shares. Now the researchers are wondering “what’s next?” Dr. Bentley says, “What study can we do that would make this a better therapy for humans? That’s something that’s awesome about this type of research. When we use dogs as test subjects, they and their families can benefit from these studies for human subjects. “We’re frustrated when a new therapy comes out that’s only been tested on humans because no one has any idea if it’s safe in dogs or what the dosage is for dogs. But when it starts with dogs, we can benefit dogs and later adults and children with brain cancer,” he adds. Another benefit is that when

“There are still too few of us. There are whole areas of the country with no neurological vets.”

– Dr. Timothy Bentley the researchers do work that also benefits humans, they’re eligible for money available for human research—and there’s a lot more money available for human research. Besides the herpes virus study, Dr. Bentley is also working with a biomedical engineer at Purdue, Dr. Hugh Lee, who has created a tiny device—less than a millimeter—for hydrocephalus patients. “Hydrocephalus is where spinal fluid builds up in the brain and causes neurological problems. The typical treatment is a shunt in the brain that drains this fluid to the abdomen to be easily handled. However, the shunt can get obstructed. This device is a tiny metal piece that connects to the shunt, and because there is no battery, it never runs out of juice. It’s similar to recharging your phone on one of those magnet rechargers. We’re still in the pre-clinical phases of this, but we’ve tested it with pigs and have a publication with the reviewers right now,” Dr Bentley shares.

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THE NEED FOR CANINE BRAIN SPECIALISTS Dr. Bentley said when he considered specializing in canine brain health, his options were few: “There were two programs in the U.K. and seven in North America. Those were my options for an English-speaking program.” He completed his residency training at Tufts and moved to Purdue in 2009. “Now, there are six canine neurosurgeons in Indiana. There are still too few of us. There are whole areas of the country with no neurological vets,” he says. Dr. Bentley recommends specializing if there is a certain area of veterinary medicine that you’re drawn to. “I think everyone eventually gets bored doing the same thing over and over. I’ve been out of veterinarian school for 16 years. I like doing more and more complicated surgeries. I enjoy being that little bit more advanced,” he concludes. A web writer since 2005, Jen’s written over 1,000 articles on pet-related topics. She works with veterinarians and pet professionals around the world to help them attract and retain customers through effective content marketing practices. Passionate about both pets and digital marketing, you can find out more at jenphillipsapril.com. When not working with her fabulous clients, you can find her eating tacos and practicing her Spanish in her adopted home of the Riviera Maya.

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BEYOND THE STETHOSCOPE

KEY By Angela Demaree, DVM, MPH, CHPC

his time of year, we often take time out of our busy days to spend with friends and family during the holidays, and we may even find ourselves considering a career transition as one of our New Year’s goals or resolutions. But what happens if you take that career leap of faith? Is it the right next step to get where you want to go if you aren’t quite sure where exactly that is? Perhaps we didn’t accomplish that ever-elusive goal or dream that has been on our minds this year, but we are just too busy and don’t have enough time, money or energy to pursue it. If you are finding yourself saying, “Next year will be different,” then now is the time to dream again and think about how you want your life to look and feel. What does success mean to you? Whenever I feel “off” or lost, wondering how I got here, I finish this simple phrase

and remind myself of what is most meaningful to me right now: “I feel successful when….” This journal prompt can, in an instant, re-center you and remind you of what is most important and meaningful right now, at this moment. Then, ask yourself to complete this sentence: “I can accomplish this by….” Any time you find yourself saying, “I can’t” or “it’s not possible for me,” that’s a clue to rephrase that thought into, “but if I could, how might I accomplish this? What can I do to get one step closer?” Success is deeply personal and different for everyone, which is why, “What’s your definition of success?” is one of my favorite questions to ask on my podcast. Here is my favorite way to align goals and dreams, no matter my current situation, to achieve my definition of success with the three steps to “Key Decision Framework:”

1. Complete the sentence, “I feel successful when Write this at the top of the page in big, bold letters and make sure it resonates with you. If you accomplish this, even if it’s not how you imagined, will you still feel successful? Can you change your perspective on how you have to accomplish being successful? Keep working through this process until you can let go of “how” you accomplish your definition of success. Then, you might even realize that you are successful right now, at this moment, and are living the life of your dreams. How cool is that?! 30

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.”

2. List your goals in each of the five key areas of life. The five key areas of life are Health (physical, mental, wellbeing), Relationships (interacting with others), Career (mission, purpose, improving skillsets), Spirit (hobbies, spiritual) and Finances.

3. Ask yourself, “What is the one key decision that I can make or have been avoiding making that would help me progress towards my goals in ALL five areas?” These areas of life are not mutually exclusive, yet all intertwine and overlap. Think of a Venn diagram with five circles, one for each of the five areas of life. Write your goals in each of the five circles, then ask yourself, “What’s in common with them all?” And, finally, “What would be the key decision that fits into the overlapping space?”

That decision might be about a hobby you’ve been putting off, but when you look at your life holistically, it’s the one decision that is like a stick stuck in the wheel of your bike. When you remove that obstacle, it propels you forward in all areas, or unlocks the wheels of your bike, so that you can more clearly see opportunities to accomplish all of these seemingly disparate goals.

There is no one right way to achieve your goals and dreams. They are your dreams, so dream big, live life to the fullest and enjoy this crazy journey we call life.  Dr. Angela Demaree is the CEO and Principal Consultant for PAWS Consulting, a public health and political consulting firm. Angela recently retired as a Major in the United States Army Reserves, is a Certified High Performance CoachTM and the host of Beyond the Stethoscope, the podcast for veterinarians and busy professionals who want actionable, implementable solutions surrounding work-life balance, accomplishing your goals and living your dreams. She spends her free time with her horse, Tommy and teaching her Quaker Parrot the Purdue Fight Song. You can connect with Angela on Twitter and LinkedIn @DemareeDVM.

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PETVET TOp 10 1 December is

Ten things to DO

Want to “own” the practice you work at? Galaxy Vets, a new healthcare system co-owned by its employees and with burnout prevention as a strategic priority, is launching nationwide. More information and qualification criteria are available at galaxyvets.com

Run a promotion during the month of December for discounted feline wellness exams to encourage your clients to show their cats some love.

3 Have you tried yuzu fruit? Yuzu is a distinctly sour tangerine-sized citrus fruit that’s mainly cultivated in parts of Asia and is generally used for its zest and juice to flavor sauces and dressings. Like other citrus fruits, it is high in vitamin C and rich in antioxidants.

We’ve all heard of an LVT, an RVT & a CVT but what about a chief veterinary technician? (also a CVT)? This role is beginning to pop up in practices across the country, putting the individual in charge of the veterinary technician workforce and related patient care services. Maybe it’s time to give your favorite tech a promotion!

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4 Want to relieve some stress, have a laugh

and be creative?

Buy yourself (or a friend) the snarky and funny adult coloring book just for vets, I Was Made For Saving Animals, available on Amazon.

portrait created by www.facebook.com/IvyFox.illustration/

this month

7 january is

Customized gifts are

all the rage. From hand-drawn pet portraits to personalized cutting boards, consider gifting something thoughtful to those you care about this holiday season. (Bonus if it’s from a local artist or small business!)

Challenge your staff or clients to see who can cover the most distance with their pet during the month of January and reward the winner with a prize.

9 holiday decorations last year If you scaled back your

in light of a smaller guest list, this year you can plan to go big to make up for it! Try out some dramatic décor such as showstopping tablescapes, nontraditional color palettes, large print fabrics and natural elements like birch logs.

Looking for a more serious, heartfelt read?

10 toNewkickYear’soffresolution 2022?

Check out the newly-released The Forgotten Nurses: Finding Peace and Purpose in the Stressful World of Veterinary Medicine by Tracy L. Bittner, LVT, available on Amazon.

Plan your days! Make a to-do list for each day and put it somewhere you check often (like in your phone!) When you have a plan set for your day, you’ll be surprised how much more you get done.

Need a simple yet effective

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