Advisory Work Research Articles

Monkeypox: Cutaneous clues to clinical diagnosis

Monkeypox: Cutaneous clues to clinical diagnosis

Struggle of the principles of universalism and specialization in the Soviet higher medical education of the post-war period (on the example of the Kuibyshev Medical Institute in 1945–1955)

The article attempts to characterize the results of the struggle between the supporters of universalism and specialization in the field of higher medical education in the post-war period, based on the analysis of sources and literature. It is concluded that in 19451955 the trend towards specialization was more influential. The main forms of specialization characteristic of this period are singled out subordination, for the passage of which the sixth year of medical and preventive faculties was assigned, and specialized faculties. The most important factors that influenced both the process of strengthening specialization as a whole and its individual forms are identified. In particular, the relationship between the reform of E.I. Smirnov and the introduction of subordination, as well as strengthening the advisory and medical work of employees of medical universities. It is concluded that the formation of military medical and sanitary-prophylactic faculties in the post-war decade was the result of a correspondingly tense international situation and government changes in the field of control over compliance with sanitary and hygienic standards. In addition, the article touches upon issues related to the curtailment of the course towards specialization in the mid-1950-ies. The problem of the relationship between the discussion about the industrial and territorial organization of health care, on the one hand, and the opposition of tendencies towards universalism and specialization, on the other hand, is analyzed. A hypothesis has been put forward, according to which the reorganization of the public health system in accordance with the ideas of the supporters of the industrial approach contributed to the strengthening of specialization in the field of medical education. The changes that have taken place in this period in the higher medical school are considered on the example of the development of the Kuibyshev State Medical Institute.

DNA vaccines join the fight against COVID-19

DNA vaccines join the fight against COVID-19

Influences of Digital Innovations on Advisory Work in the Financial Services Sector

We explore the background, changes, and challenges of the digital transformation of customer advisory in the financial services sector resulting from the implementation of new technological solutions. In addition, we examine the effects of the adoption of digital innovations on advisory work. Building on insights drawn from a multiple case analysis within two financial services providers and using the Technology-Organization-Environment (TOE) framework as the theoretical basis, our study identifies 13 factors that influence advisory work when technological innovations are introduced. We provide implications for financial services providers with regard to the identified influencing factors. Our results and findings expand the academic knowledge and understanding of the chances and challenges in the context of introducing technological innovations for financial advisory. Practitioners can use our insights for future implementations of technical solutions supporting advisory work.

РЕГУЛИРОВАНИЕ АРХЕОЛОГИЧЕСКОЙ ДЕЯТЕЛЬНОСТИ В РЕСПУБЛИКЕ КАЗАХСТАН

The article deals with issues of regulation of archaeological activity in the Republic of Kazakhstan. The Ministry of Culture and Sports of the Republic of Kazakhstan regulates the preservation of archaeological sites, as well as the organization of archaeological, expert and advisory work. The study of sites is carried out by employees of subordinate organizations of both the Ministry of Culture and Sports and the Ministry of Education and Science. Disunity and methodological issues that have not been worked out between the two departments cause damage to the preservation and study of archaeological sites. An analysis of two laws and six by-laws revealed the existing problems, and some ways have been proposed to solve this issue.

ДИДЖИТАЛІЗАЦІЯ ЛОГІСТИКИ АГРОПРОДУКЦІЇ МІЖ ВЛАСНИКОМ – ГОСПОДАРЕМ ЗЕМЛІ ТА СПОЖИВАЧЕМ У СИСТЕМІ КОНТРОЛІНГУ

More than a third of Ukraine's population lives in rural areas. Possessing most of the agricultural land, they never became the real owners of their own lands. The current intellectual developments should be used, which can simplify the mechanism of production and sale of products grown in rural areas. There are many questions about mentality that are difficult to overcome to integrate the effect of scale. One of the options for a democratic form of cooperation and the use of the effect of scale is management based on the principles of cooperation. The latter operate successfully in other countries, at the same time having a profitable historical past in Ukraine during the reign of Count Andrei Sheptytsky. However, at present, it is difficult for small and medium-sized landowners to coexist in such an organizational and legal form. In addition to significant advisory work to be carried out by economists, historians, psychologists, lawyers, lawyers with rural populations, we have designed an online platform that helps remove barriers to joint business for small and medium landowners, sales of their products, delivery of products to the consumer, etc. The purpose of the article is to substantiate the sections of communication between producers and consumers created on the Internet platform, modernization of logistics processes of product delivery. The methods of deduction, induction, analysis, synthesis, dialectics, forecasting were used. In the given scientific work it is determined that the problem of establishing entrepreneurship and, at the same time, socio-economic strengthening of landowners is primarily the lack of a comprehensive understanding of the organization of business processes. The scale of these problems has led to our digitalization to such processes as: ordering and offering goods, services, technologies, investments. These are key elements that serve to organize business, in particular in the agricultural sector of the economy. It is determined that an important role in this belongs to the construction of electronic routes for delivery of products (product complex) from producer to consumer. Crucial in this is the construction of the address database of the end user. The practical significance of this development is that a competent interpretation of its inherent functionality can solve a significant number of problems of millions of landowners.

Anneke Brand (1946-2021).

Anneke Brand, Professor in Transfusion Medicine, passed away on Sunday, 21 November 2021, at the age of 75. She was a pioneer in both the immunological and clinical aspects of blood transfusion. She has played a pivotal role in the development of the Dutch Cord Blood Bank. During her entire career, she was dedicated to inspiring many researchers and clinicians alike in the field of transfusion medicine and haematology. Her ability to question and challenge scientific findings, as well as many social issues, is unequalled. Anneke was born on 7 June 1946 in The Hague, the Netherlands. In 1973, she obtained her medical degree from the Free University Amsterdam and was accepted for a PhD project at the Department of Immunohaematology and Blood Bank of the Academic Hospital Leiden under the wings of Prof. Jon van Rood and Dr George Eernisse. In this project, she started working on the management of patients refractory to platelet transfusions, including antibody detection and donor selection. In those days, many leukaemia patients suffered from severe bleeding complications and presented with unexplained severe transfusion reactions and markedly reduced post-transfusion increments. In the laboratory of the Immunohaematology Department, important aspects of the human leukocyte antigen (HLA) class type I system were unravelled and the first sibling bone marrow transplants for severe combined immunodeficiency and aplastic anaemia patients were performed. Laboratory tests to detect HLA antibodies were developed. In 1978 she defended her thesis ‘Platelet Supportive Care’, and meanwhile learned all aspects of blood-banking. After this, she started her training in internal medicine in Haarlem, followed by her specialization in haematology at the Leiden Academic Hospital. As a medical specialist, in 1984 she returned to the Blood Bank and Haemapheresis Department, combining patient care and clinical research, investigating the role of leukocytes on clinical transfusion outcomes in various disorders, from colorectal cancer surgery to erythrocyte alloimmunization. Her research led to the adoption of leukoreduction to diminish alloimmunization as well as other adverse transfusion reactions. After a sabbatical in Paris in the laboratory of Prof. Michel Kazatchkine working on anti-idiotypic antibodies in intravenous immunoglobulins, in 1988 she succeeded George Eernisse as Medical Director of the Red Cross Leiden and the Blood Bank of the Leiden University Hospital. After the AIDS drama, good manufacturing practice became mandatory and regional Dutch blood banks merged with neighbouring blood banks. Over a period of 10 years, all Dutch Red Cross blood banks gradually merged with the Dutch Laboratory of the Red Cross to form one national organization: Sanquin. In 1994, together with Fred Falkenburg, she established the Dutch Cord Blood Bank, a joint effort between the Leiden University Medical Centre and the Red Cross Blood Bank. In 1995, she joined the Royal College of Pathology, and in 1999 she became Professor of Internal Medicine with assignment to Transfusion Medicine. In that period, she started researching the optimal conditions for the storage and expansion of cord blood for transplantation as well as exploring the possibility of using cord blood to produce red blood cells for transfusion. From 2000 till her ‘age-enforced’ retirement in 2011, she was the head of clinical research at Sanquin Blood Bank Southwest. In this period, several clinical trials were successfully conducted, including studies regarding peri-operative blood management strategies as well as several clinical platelet transfusion trials. After her retirement, she remained active in many fields, including the board of the European Haematology Association (2012–2016), Europdonor (till 2015), and advisory work for TRIP, the Dutch Haemovigilance network. She received the Claes Högman Lecture Award of the Swedish Blood Transfusion Society (1997), the Blundell Award of the British Blood Transfusion Society (2009), the Presidential Award of the International Society of Blood Transfusion (2020), and, very recently, the Landsteiner Award (2021). Scientifically, she continued working on non-inherited maternal antigens, an interest she shared with Jon van Rood, and studying factors that influence erythrocyte alloimmunization. Only recently were we informed that Anneke was severely and incurably ill, and her passing away was abrupt. We will remember her words of comfort, wisdom, and inspiration, as we will remember her tremendous scientific drive and encyclopaedic up-to-date knowledge in many fields of medicine. We will never forget the detailed questions she used to have at the end of every lecture she attended, aiming to improve the quality of everyone's contribution to transfusion medicine. She will be deeply missed by her family, friends, and colleagues.

Особливості практичної підготовки студентів-логопедів Сумського державного педагогічного університету імені А. С. Макаренка в медичних закладах та інклюзивно-ресурсних центрах

The article highlights the organizational, methodological and substantive features of the training and production practices of future speech therapists at Sumy State Pedagogical University named after A.S. Makarenko according to the educational program 016 Special education (Speech therapy). The authors determined that the peculiarity of the internship depends on and is determined by the professional qualifications of the teacher-speech therapist, which provides for the training and internship on the relevant bases (secondary and special educational institutions, medical institutions, social rehabilitation institutions and inclusive resource centers) formation of applicants with the necessary professional competencies for effective future professional activity. According to the educational program and curriculum, the internship is conducted in special and general educational institutions of preschool education (4 th semester), in general secondary education institutions (5 th semester), in general special educational institutions, medical institutions and IRC (6 th semester). Industrial practice is carried out in all these institutions in the speech therapist positions (8 semester). Responsibility for the organization, conduct and control of practice rests with the leadership of Sumy State Pedagogical University named after A.S. Makarenko: rector and vice-rector for scientific and pedagogical (educational) work. The general organization, carrying out and control of practice is provided by the department of practice of Sumy State Pedagogical University named after A.S. Makarenko and the Speech Therapy Department. Methodical guidance of the practice is carried out by a responsible methodologist from the specialist of the Speech Therapy Department, who works directly at the speech therapy practice sites. Special attention is paid in the article to the coverage of the training and production practices specifics by future teachers-speech therapists at medical institutions and inclusive resource centers. During the internship in medical institutions, applicants get acquainted with the speech therapist specifics and learn to provide specialized speech therapy counseling and diagnostic, developmental and correctional care for different ages people and with various developmental and health disorders. As a teacher-defectologist of the inclusive resource center, applicants get acquainted with their future profession peculiarities at this institution and master the advisory, diagnostic, correctional, developmental and educational-methodical work areas.

До питання про роботу логопеда в умовах інклюзивного навчального простору

The proposed article presents the results of the analysis of legislative documents and scientific and methodological literature in the field of speech therapy in an inclusive environment. Speech therapist at the beginning of the school year based on the results of the survey of students, in case of speech disorders that require long-term assistance or specially organized training, suspicions of other developmental disorders - recommends parents (other legal representatives) of the child to contact the inclusive resource center for comprehensive psychological pedagogical assessment of child development. The conclusion of the inclusive resource center on a comprehensive psychological and pedagogical assessment of the development of a child with special educational needs notes the features of the child's speech competence (knowledge, abilities, skills, etc.), the needs and recommendations for speech therapist, and the number of hours for correctional developmental speech therapy services. After receiving an opinion on the comprehensive assessment, the educational institution, represented by the head of the institution, enters into an agreement with a speech therapist to provide correctional and developmental services to a child with special educational needs who is studying in an inclusive form. Based on the conclusion of the comprehensive assessment, an Individual Development Program is drawn up, which states that the speech therapist is a member of the team of psychological and pedagogical support of the child. Speech therapist, being a member of the team of specialists who provide psychological and pedagogical support to children with special educational needs in an inclusive educational space, performs: diagnostic, developmental, organizational and methodological, advisory and educational work. Special pedagogical activity of a speech therapist is carried out on the basis of the program included in the structure of the basic educational program of the general educational institution. Based on this, the main activities of a speech therapist are determined in the framework of psychological and pedagogical support of children with special educational needs who study in an inclusive space. During the school year, the speech therapist draws up the following documents: a speech card for each child, long-term and calendar work plans, individual notebooks for each child, an annual report on the results of correctional training. The speech therapist participates in school methodological associations, meetings of the inclusive resource center, replenishes the speech therapy office with new methodological and didactic literature. Each activity of a speech therapist is included in a single process of psychological and pedagogical support and within the framework of inclusive education acquires special significance. That is, it is focused not only on overcoming speech disorders in students with special educational needs, but also on their socialization and adaptation among peers with normo-typical development. Thus, the activities of a speech therapist in an inclusive environment are not limited to corrective action. Promoting the socialization of children with speech disorders is becoming increasingly important. Because it is speech disorders that become an obstacle on the way to communication of children with speech disorders with other children and teachers. Overcoming speech disorders contributes to the formation of a child with special educational needs self-confidence, the development of its cognitive abilities. A speech therapist can be the person who will help a child with special educational needs to build relationships in the school community and beyond.

Process expertise in policy advice: Designing collaboration in collaboration

Complex societal and environmental challenges motivate scholars to assume new roles that transcend the boundaries of traditional academic expertise. The present article focuses on the specialised knowledge, skills, and practices mobilised in the context of science–policy interfaces by researchers who advise policymakers on collaborative governance processes intended to address these pressing issues. By working on the backstage of collaborative arrangements, researchers support policymakers in the co-design of tailor-made strategies for involving groups of institutional and non-institutional actors in collaboration on a specific issue. The present article examines the expertise underpinning this practice, which we term process expertise. While already quite widely practiced, process expertise has not yet been comprehensively theorised. The study employs a self-reflective case narrative to illuminate its constitutive elements and investigates the advisory work of the authors’ research team, called “Co-Creation and Contemporary Policy Advice”, located at the intersection of science, policymaking, and civil society. The findings show that process expertise, when exercised by researchers and supported by an assemblage of enabling conditions inherent to the research context, goes beyond the possession of a set of skills at the individual level. Instead, process expertise in the context of science–policy interfaces unfolds in interaction with other types of knowledge and fulfils its task by generating a weakly institutionalised “in-between space”, in which researchers and policymakers interact to find more inclusive ways of tackling complex challenges. In this realm, relational work contributes to establishing a collaborative modus operandi at the very outset of the advisory process, while working at the processual level supports knowledge co-production among multiple actors. The article argues that it is the ongoing work of process experts at the intersection of relational and processual levels that helps maintain momentum in these collaborative partnerships. By formulating and discussing five constitutive elements of process expertise, this paper untangles the complex work that is required in collaborative research settings and gives a language to the invisible work performed by researchers who offer policymakers—and other invited actors—advice on the process of designing collaboration in collaboration.

Individualized Fluid and Vasopressor Therapy: Comment

We read with great interest the randomized controlled trial published recently by Joosten et al. in Anesthesiology.1 This study assessed the ability of a closed-loop system for the titration of a norepinephrine infusion combined with a fluid-management decision support system to decrease the percentage of intraoperative time at risk for tissue hypoperfusion when compared with a “traditional” manually controlled goal-directed hemodynamic optimization. The authors reported that patients in the computer-assisted group had significantly less total intraoperative time with hypotension (primary outcome), less oscillation in mean arterial pressure (MAP) during surgery, and a higher mean cardiac index at the end of the procedure—while also receiving less total norepinephrine by infusion and having a lower fluid balance.1We congratulate the authors for having performed such innovative research on perioperative hemodynamic optimization to improve patient’s postoperative outcome. Nonetheless, we have a few comments and questions.Dr. Cholley has received honoraria for participation on advisory boards and lecturing fees from Edwards Lifesciences (Irvine, California), Orion Pharma (Espoo, Finland), Amomed (Wien, Austria), and Nordic Pharma (Paris, France). Dr. McCluskey has received honoraria from Edwards Lifesciences for advisory work and speaker’s support. The other authors declare no competing interests.

The CFE’s Contribution to European Taxation’s 60th Anniversary Issue: 60 Years of Tax Advisory Work in the Area of EU Tax Policy

In this note, the CFE comments on 60 years of tax advisory work in the area of EU tax policy. The CFE emphasizes that effective cooperation between tax advisers implies a stronger impact on EU and international tax developments, and hence a more robust protection of taxpayer rights. This is particularly important in the face of the current challenges facing the tax advisory community, such as the digitalization of the economy.

What's luck got to do with it? Commentary on Rowland and Spaniol (2021)

AbstractThis commentary refers to the retrospective review by Rowland and Spaniol in Futures and Foresight Science (2021), which provides interesting insights into Kees van der Heijden's character and work 25 years after his famous book Scenarios: The art of strategic conversation was first published. The commentator draws on his own personal experience of Kees' work and book, including a seminar with him at the University of Oxford in 2011, as well as applying the book's fundamentals in his own research and advisory work over the past ten years.

Group psychological counselling as a form of prevention of adolescent addictive behaviour

This article provides an analysis of domestic and foreign literature on the concept of “adolescent addictive behaviour,” summarises its scientific understanding, and outlines the mechanisms of the emergence of addictive behaviour and psychological characteristics of adolescents exhibiting addictive behaviour. The study presents a review of modern research on the problems of Internet-, food-, and alcohol addictions. The review includes Russian, Kazakh and international literature on the psychological prevention of adolescent addictive behaviour. The concept of the “psychological prevention of adolescent addictive behaviour” is disclosed, and the principles and objectives of preventive work with adolescents prone to addictive behaviour are defined. A set of diagnostic techniques is proposed to study the predilection of adolescents to addictive behaviour. The article reveals the content and effectiveness of the programme for the psychological prevention of adolescents’ predisposition to addictive behaviour by means of group psychological counselling. The authors describe the course of experimental work on the study of adolescents’ predisposition to addictive behaviour, present the testing of the developed psychological programme, and demonstrate the effectiveness of adolescents’ group counselling to prevent their addictive behaviour. The results of the study confirm the authors’ hypothesis that the use of group forms of psychological counselling is effective in psychological prevention, as it relies on the activity of adolescents. The results of the study contribute to the development of preventive pedagogy and psychology, and the improvement of the modern system of anti-alcohol and anti-drug education of adolescents. The study findings can be also used in educational institutions in advisory and remedial work with adolescents.

Recruitment, risks, rewards and regrets: Senior researcher reflections on working with alcohol industry social aspects organisations.

A growing body of literature suggests alcohol industry corporate social responsibility activity, including the creation of 'social aspects' organisations (SAO), may harm rather than improve public health. We aimed to explore established researcher experiences of working with SAOs, and the factors informing their decisions to do so. Qualitative interview study with senior alcohol researchers who had previous or ongoing connections to SAOs or their predecessors initiated when their careers were established (n= 16). Thematic analysis using NVivo software. Established researchers were recruited for their expertise by alcohol industry SAOs via employees who were previously academics or via academic colleagues with SAO connections. Motivated by the desire to improve public health and 'reach out' beyond academia, researchers were confident that they could maintain their independence when sharing their expertise with SAOs. Short-term connections included attendance at SAO-funded events and book chapter contributions. Sometimes, these led to long-term relationships with SAOs, or researchers were invited to long-term roles by a colleague. These included memberships of scientific advisory committees, board positions, or work as independent consultants. Most researchers reflected negatively on their experiences and had ended their associations, while some had positive experiences. Current and former researchers play key roles in initiating connections with SAOs, with industry-funded events and invitations to long-term roles by trusted colleagues, mechanisms used to facilitate the development of such relationships. Our study adds to existing evidence that SAO scientific activity does not contribute to public health goals, but does present industry with public relations opportunities.

Chronic nociplastic pain affecting the musculoskeletal system: clinical criteria and grading system.

Chronic nociplastic pain affecting the musculoskeletal system: clinical criteria and grading system.

Casirivimab-Imdevimab Treatment Is Associated with Reduced Rates of Hospitalization Among High-Risk Patients with Mild to Moderate Coronavirus Disease-19

Background: Real-world clinical data to support the use of casirivimab-imdevimab for the treatment of outpatients with mild to moderate coronavirus disease-19 (COVID-19) is needed. This study aimed to assess the outcomes of casirivimab-imdevimab treatment of mild to moderate COVID-19.Methods: A retrospective cohort of 696 patients who received casirivimab-imdevimab between December 4, 2020 and April 9, 2021 was compared to a propensity-matched control of 696 untreated patients with mild to moderate COVID-19 at Mayo Clinic sites in Arizona, Florida, Minnesota, and Wisconsin. Primary outcome was rate of hospitalization at days 14, 21 and 28 after infusion.Findings: The median age of the antibody-treated cohort was 63 years (interquartile range, 52-71); 45·5% were ≥65 years old; 51·4% were female. High-risk characteristics were hypertension (52·4%), body mass index ≥35 (31·0%), diabetes mellitus (24·6%), chronic lung disease (22·1%), chronic renal disease (11·4%), congestive heart failure (6·6%), and compromised immune function (6·7%). Compared to the propensity-matched untreated control, patients who received casirivimab-imdevimab had significantly lower all-cause hospitalization rates at day 14 (1·2% vs 3·4%; Odds Ratio [OR], 0·26; 95% confidence interval (CI): 0·11-0·64), day 21 (1·2% vs 4·2%; OR, 0·22; 95% CI: 0·09-0·52), and day 28 (1·3% vs 4·9%; OR, 0·21; 95% CI: 0·09-0·48). Rates of intensive care unit admission and mortality at days 14, 21 and 28 were similarly low for antibody-treated and untreated groups.Interpretation:Among high-risk patients with mild to moderate COVID-19, casirivimab-imdevimab treatment was associated with a significantly lower rate of hospitalization.Funding Information: This work was funded by an intramural grant from Mayo Clinic to RRR.Declaration of Interests: CP, AP, AV, and PL are employees of nference and have financial interests in the company. JCO is supported by grants from nference, and is a paid consultant for Elsevier, Inc. and Bates College. ADB is supported by grants from NIAID (grants AI110173 and AI120698) Amfar (#109593) and Mayo Clinic (HH Shieck Khalifa Bib Zayed Al-Nahyan Named Professorship of Infectious Diseases). ADB is a paid consultant for Abbvie and Flambeau Diagnostics, is a paid member of the DSMB for Corvus Pharmaceuticals and Equilium, owns equity for scientific advisory work in Zentalis and Nference, and is founder and President of Splissen therapeutics. RRR is supported by research grants from Regeneron, Roche, Gilead and the Mayo Clinic, and is a member of DSMB for Novartis. All other have nothing to disclose. Ethics Approval Statement: The Mayo Clinic Institutional Review Board approved this study. Informed consent was waived and patients without research authorization were excluded.

Research priorities for exacerbations of COPD

Research priorities for exacerbations of COPD

Socio-pedagogical factors of family relationships within the COVID-19 pandemic

The article deals with the influence of the COVID-19 pandemic on family relationships. It is noted that any family has been in a difficult position for more than a year, which has adversely affected all areas of its livelihoods and led to an increase in the number of divorces, and, as a result, of incomplete families. Therefore, it is not surprising that family problems, family relationships, attract scientists’ particular attention. Taking into account the importance and relevance of the outlined problems, we have analysed the factors of interpersonal interaction which negatively affect family well-being; they are: conflict relations between spouses, increased emotional tension, lack of communication, the authority of one of spouses, misunderstanding and imposing of inadequate social roles, low level of culture in family relationships. To determine the impact of quarantine on family relationships, a questionnaire was developed on the on-line platform of Google-Forms. 84 married couples were involved into a survey. The analysis of the results testified that in a third of the polled families who took part in the study, significant problems associated with the organisation of family life under conditions of the quarantine arose. This is the evidence that members of the family are not able to spend time together, they lack joint topics and interests, lacking respect and mutual understanding or tolerance towards each other. Working with various types of families (prosperous, non-social, those with low-income, large families), it is necessary for a social worker to take into account the peculiarities of working with different families and, on this basis, to use adequate forms and methods of work. In order to prevent destructive consequences caused by the COVID-19 pandemic, social workers need to strengthen advisory work in on-line and offline formats for the importance of communication within interpersonal relationships, demonstrating openness and trust in relations, adequate behavioural models in conflict situations. Socio-pedagogical work with the family within a quarantine should be aimed at restoring lost trust, harmonisation of married couples’ relationships, creating a favourable microclimate in the family. An important step in raising the culture-related level of family relationships is the creation of innovative complexes of programs by social service centres intended for families, children and youth on the on-line platforms.

Models for charging in practice: how should farm veterinary surgeons earn their living?

There are many different ways that practices use for charging farm clients for their professional services. Ideally, the model is equitable for veterinary surgeon, client and animal. Different structures can influence how a practice's services are used and which services are successful. This article, which is an opinion piece, reviews common fee charging structures in UK farm practice. An argument is presented that if practices progressed towards a subscription-style charging model, at least for advisory work, and possibly for out-of-hours emergency work, this could be beneficial to farm businesses, veterinary businesses, farm veterinary surgeons, and the animals under their care.