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Siobhan Mullan Department of Clinical Veterinary Science, University of Bristol Veterinary School, Bristol, UK Abstract: Quality-of-life assessments aim to provide an all-encompassing evaluation of animal welfare. In comparison to more limited, disease-focused welfare assessments, they have the potential to better identify welfare deficiencies, allowing veterinarians to target improvement strategies for greater benefit. Individuals or populations of companion animals may be assessed and carers and/or veterinarians may contribute to the assessment. Quality-of-life assessments are widely used within the human health care setting, and although the number of veterinary assessment tools is substantially fewer, these tools cover a range of methodologies. Further research to validate existing tools and develop new ones is recommended. Guidance for implementing and evaluating the usefulness of quality-of-life assessment tools within companion animal veterinary clinics is presented. Keywords: quality of life, welfare, companion animals, veterinary practice, evidence-based veterinary medicine

Objectives: To develop and validate an index predictive of adverse perinatal outcome (APO) in pregnancies meeting the consensus‐based criteria for fetal growth restriction (FGR) endorsed by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). Methods: This was a retrospective analysis of consecutive singleton non‐anomalous gestations meeting the ISUOG‐endorsed criteria for FGR at a single tertiary care center from November 2010 to August 2020. The dataset was divided randomly into a development set (two‐thirds) and a validation set (one‐third). The primary composite APO comprised one or more of: perinatal demise, Grade III–IV intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), seizures, hypoxic ischemic encephalopathy (HIE), necrotizing enterocolitis (NEC), sepsis, bronchopulmonary dysplasia (BPD) and length of stay in the neonatal intensive care unit (NICU) > 7 days. Regression analysis incorporated clinical factors readily available at the time of FGR diagnosis. The sum of β coefficient‐based weights yielded an index score, the performance of which was assessed in the validation set. Score cut‐offs were selected to identify 'high‐risk' and 'low‐risk' ranges for which positive (PPV) and negative (NPV) predictive values and positive (LR+) and negative (LR–) likelihood ratios were calculated. Results: Of the 875 consecutive pregnancies that met the criteria for FGR and were included in the study cohort, 405 (46%) were complicated by one or more components of the composite APO, including 54 (6%) perinatal deaths, 22 (3%) neonates with Grade III–IV IVH and/or PVL, nine (1%) with seizures and/or HIE, 91 (10%) with BPD, 57 (7%) with sepsis, 21 (2%) with NEC, and 361 (41%) who remained in the NICU > 7 days. In addition, 270 (31%) pregnancies were delivered by Cesarean section for non‐reassuring fetal status, 43 (5%) were admitted to the NICU for < 7 days, 79 (9%) had 5‐min Apgar score < 7, 125/631 (20%) had a cord gas pH ≤ 7.1 and 35/631 (6%) had a base excess ≥ 12 mmol/L. The predictive index we developed included seven factors available at the time of FGR diagnosis: hypertensive disorder of pregnancy (HDP) (+8 points), chronic hypertension without HDP (+4 points), gestational age ≤ 32 weeks (+5 points), absent or reversed end‐diastolic flow in the umbilical artery (+8 points), prepregnancy body mass index ≥ 35 kg/m2 (+3 points), isolated abdominal circumference < 3rd percentile (−4 points) and non‐Hispanic black race (−2 points). The bias‐corrected bootstrapped (1000 replicates) area under the receiver‐operating‐characteristics curve (AUC) of the predictive index for composite APO in the validation group was 0.88 (95% CI, 0.84–0.92), which was similar to that in the development group (AUC, 0.86 (95% CI, 0.82–0.89); P = 0.34). In the total cohort, 40% of pregnancies had a low‐risk index score (≤ 2), associated with a NPV of 85% (95% CI, 81–88%) and a LR– of 0.21 (95% CI, 0.16–0.27), and 23% had a high‐risk index score (≥ 10), associated with a PPV of 96% (95% CI, 93–98%) and a LR+ of 27.36 (95% CI, 14.33–52.23). Of the remaining pregnancies that had an intermediate‐risk score, 50% were complicated by composite APO. Conclusion: An easy‐to‐use index incorporating seven clinical factors readily available at the time of FGR diagnosis is predictive of APO and may prove useful in counseling and management of pregnancies meeting the ISUOG‐endorsed criteria for FGR. © 2022 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic and associated restrictions have caused major changes in veterinary practice. Utilising a subset of qualitative data from a global survey of 540 veterinarians, veterinary nurses and animal health technicians, we highlight the impact of these changes on communication in veterinary clinical practice. Communication challenges experienced by veterinary team members included lack of face‐to‐face contact with clients; increased difficulty in communicating in general; inability to demonstrate physical examination, diagnostic findings or treatment information to clients; difficulty in communicating while wearing personal protective equipment; increased 'miscommunication' and challenges in convincing clients of the importance of pandemic‐associated protocols. These findings suggest a need for veterinary teams to modify and adapt their communication strategies to facilitate effective communication where social distancing and noncontact consultations are required. [ABSTRACT FROM AUTHOR]