@article{scharf_mcphetridge_dickson_2022, title={Sleep patterns, fatigue, and working hours among veterinary house officers: a cross-sectional survey study}, volume={260}, ISSN={["1943-569X"]}, DOI={10.2460/javma.21.05.0234}, abstractNote={To describe the sleep patterns, working hours, and perceptions of fatigue among veterinary house officers and to identify potential areas for targeted intervention to improve well-being.303 house officers.A 62-item questionnaire was generated by use of an online platform and sent to veterinary house officers at participating institutions via email. Responses were analyzed for trends and associations between variables of interest.The mean age of respondents was 30 ± 3.7 years. Participants included 239 residents and 64 interns. House officers slept significantly less during times when they had clinical responsibilities compared to off-clinic time (6.0 hours vs 7.5 hours, respectively; P < 0.01). The majority of house officers reported working 11 to 13 hours on a typical weekday (58% [174/302]), and 32% reported clinical responsibilities 7 d/wk. Working hours were negatively related to sleep quantity (Pearson correlation coefficient, -0.54; P < 0.01), and perceived sleep quality was worse when on call (P < 0.01). The majority of house officers felt that fatigue negatively interfered with their technical skills, clinical judgment, and ability to empathize to some extent in the previous 4 weeks.Most house officers fail to obtain sufficient sleep for optimal cognitive function and physical and mental health. Working hours and on call may be important factors contributing to the sleep patterns of veterinary house officers, and training program structure should be critically evaluated to promote protected time for sleep.}, number={11}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Scharf, Valery F. and McPhetridge, Jourdan B. and Dickson, Rachel}, year={2022}, month={Aug}, pages={1377–1385} } @article{mcphetridge_scharf_dickson_thieman_oblak_regier_skinner_tinga_townsend_wallace_et al._2022, title={Veterinary house officer perceptions of dimensions of well-being during postgraduate training}, volume={260}, ISSN={["1943-569X"]}, DOI={10.2460/javma.21.05.0233}, abstractNote={Abstract OBJECTIVE To describe veterinary house officers’ perceptions of dimensions of well-being during postgraduate training and to identify potential areas for targeted intervention. SAMPLE 303 house officers. PROCEDURES A 62-item questionnaire was generated by use of an online platform and sent to house officers at participating institutions in October 2020. Responses were analyzed for trends and associations between selected variables. RESULTS 239 residents, 45 rotating interns, and 19 specialty interns responded to the survey. The majority of house officers felt that their training program negatively interfered with their exercise habits, diet, and social engagement. House officers reported engaging in exercise significantly less during times of clinical responsibility, averaging 1.6 exercise sessions/wk (SD ± 0.8) on clinical duty and 2.4 exercise sessions/wk (SD ± 0.9) when not on clinical duty ( P < 0.001). Ninety-four percent of respondents reported experiencing some degree of anxiety regarding their physical health, and 95% of house officers reported feeling some degree of anxiety regarding their current financial situation. Overall, 47% reported that their work-life balance was unsustainable for > 1 year; there was no association between specialty and sustainability of work-life balance. Most house officers were satisfied with their current training program, level of clinical responsibility, and mentorship. CLINICAL RELEVANCE Veterinary house officers demonstrated a poor balance between the demands of postgraduate training and maintenance of personal health. Thoughtful interventions are needed to support the well-being of veterinary house officers.}, number={11}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={McPhetridge, Jourdan B. and Scharf, Valery F. and Dickson, Rachel and Thieman, Kelley M. and Oblak, Michelle L. and Regier, Penny J. and Skinner, Owen T. and Tinga, Selena and Townsend, Katy L. and Wallace, Mandy L. and et al.}, year={2022}, month={Aug}, pages={1369–1376} } @article{carroll_dickson_scharf_2021, title={Feasibility of thoracoscopic attenuation of the azygos vein as a model for portoazygos shunts: A canine cadaveric study}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13532}, abstractNote={Abstract Objective To evaluate the feasibility of thoracoscopic placement of three vascular attenuation devices by using the azygos vein as a model for portoazygos (PA) shunts and to describe the approach for thoracoscopic placement of these attenuation devices in small breed dogs. Study design Randomized, prospective, cadaveric study. Animals Cadavers of 10 adult small breed dogs. Methods Cadavers were placed in sternal recumbency with left dorsolateral obliquity, and three thoracoscopic ports were established in the right hemithorax at the mid‐10th intercostal space and dorsal third of the ninth and 11th intercostal spaces. The caudal azygos vein was thoracoscopically isolated along three adjacent segments bordered by four intercostal arteries, beginning just cranial to the first intercostal artery visualized cranial to the diaphragm. Three attenuation devices including coated cellophane, uncoated cellophane, and a 5‐mm ameroid constrictor were thoracoscopically placed around one segment in each dog. Minor port access modifications were required to improve working space and triangulation in three dogs. Ability to successfully place the device, time required for placement, endoscopic clip configuration, and complications associated with placement were recorded. Results Median dog weight was 7.7 kg (range, 1.8‐11). All attenuation devices were successfully placed thoracoscopically in all cadavers. No difference was detected in time required for placement between the ameroid constrictor and coated and uncoated cellophane (range, 2.3‐33.8 minutes, P = .8). Conclusion Ameroid constrictors and thin film bands were consistently placed via thoracoscopy around the caudal azygos vein of small breed dogs. Clinical significance These results justify further investigation of thoracoscopic PA shunt attenuation in affected dogs.}, number={2}, journal={VETERINARY SURGERY}, author={Carroll, Kenneth A. and Dickson, Rachel E. and Scharf, Valery F.}, year={2021}, month={Feb}, pages={345–352} } @article{sterman_butler_chambers_dickson_dornbusch_mickelson_selmic_scharf_schlag_skinner_et al._2021, title={Post-operative complications following apocrine gland anal sac adenocarcinoma resection in dogs}, ISSN={["1476-5829"]}, DOI={10.1111/vco.12748}, abstractNote={Describe the complications associated with surgical resection of primary apocrine gland anal sac adenocarcinoma (AGASACA) tumours study design multi-institutional retrospective cross-sectional cohort study Animals Client owned dogs with spontaneous disease using the Clavien-Dindo classification system, post-operative events were assigned and described. Logistic regression analysis was used to analyse for risk factors for a significant association with complications. One hundred sixty-one dogs were included in the analysis. The post-operative sequelae, complication, and failure to cure rates specific to the anal sac site was 14%, 17% and 1%, respectively. The majority (68%) of complications were grade II or higher, therefore requiring some form of intervention. Intra-operative complications were identified in 11 cases (7%) with anorectal wall perforation being most common. An intra-operative complication was significantly associated with post-operative complications (p < 0.001; OR 7.4) while anorectal wall perforation was the only significant risk factor on regression analysis (p < 0.001; OR 19). Surgical site infection was identified in 20 of 161 (12%) of cases. Local recurrence (LR) occurred in 18% of cases at a median of 374 days (95% CI: 318-430). The only risk factor significantly associated with LR was the presence of vascular or lymphatic invasion (p = 0.008; OR 3). Post-operative complications were relatively infrequent but the risk was significantly increased when there was an intraoperative complication during resection of a primary AGASACA tumour. This study provides information for the clinician regarding risk factors for post-operative complications.}, journal={VETERINARY AND COMPARATIVE ONCOLOGY}, author={Sterman, Allyson and Butler, J. Ryan and Chambers, Aidan and Dickson, Rachel and Dornbusch, Josephine and Mickelson, Megan and Selmic, Laura and Scharf, Valerie and Schlag, Ariel and Skinner, Owen and et al.}, year={2021}, month={Jul} } @article{dickson_scharf_nelson_petrovitch_keenihan_mathews_2020, title={Computed tomography in two recumbencies aides in the identification of pulmonary bullae in dogs with spontaneous pneumothorax}, volume={61}, ISSN={["1740-8261"]}, DOI={10.1111/vru.12905}, abstractNote={Spontaneous pneumothorax presents a unique diagnostic and therapeutic challenge in veterinary medicine, specifically with regard to accurate identification of bullous lesions. Positioning of dogs with spontaneous pneumothorax during CT has not previously been evaluated. This retrospective, diagnostic accuracy study was performed to evaluate the sensitivity, positive predictive value (PPV), and interobserver variability for detection of pulmonary bullae with dogs positioned in multiple recumbencies. Dogs underwent CT in sternal and dorsal recumbency followed by thoracic exploration via median sternotomy. Three American College of Veterinary Radiology-certified veterinary radiologists blinded to surgical findings reviewed dorsal and sternal images simultaneously. Severity of pneumothorax, degree of atelectasis, lesion location and size, and view in which lesions were most confidently identified were compared to surgical and histologic findings. Sensitivities and PPVs for bulla detection ranged from 57.7% to 69.2% and 62.1% to 78.9%, respectively. For two of the 3 radiologists, the location of bullae in the thorax was significantly associated with the recumbency in which the lesion was best identified. Degree of atelectasis was found to be associated with the ability to identify lesions (P ≤ .02). The interobserver variability for identification was good (κ = 0.670). The sensitivity of CT when performed in both sternal and dorsal recumbency is similar to that previously reported. Because the distribution of bullae is unknown prior to advanced imaging and bulla location affects which recumbency is most useful for identification, acquisition of CT images in both sternal and dorsal recumbency may improve detection of bullous lesions and aid surgical planning.}, number={6}, journal={VETERINARY RADIOLOGY & ULTRASOUND}, author={Dickson, Rachel and Scharf, Valery F. and Nelson, Nathan C. and Petrovitch, Nicholas and Keenihan, Erin K. and Mathews, Kyle G.}, year={2020}, month={Nov}, pages={641–648} }