Seasonal calving UK dairy herds: A farmer survey of fertility and veterinary services.

BACKGROUND: There is a lack of literature concerning dairy farmers' use of veterinary services and how satisfied they are with them. This study aimed to fill this gap for seasonal calving UK herds, with a focus on fertility, and included farmer perceived barriers to veterinary involvement. METHODS: A cross-sectional questionnaire (convenience sample), with 166 useable responses. RESULTS: Opportunities exist for further veterinary involvement in seasonal herds. Areas vets are least involved in currently are nutrition, breeding and genetics, growth rate monitoring and infrastructure changes. Current veterinary input was rated neutral or poor value by 21% of respondents. Over 90% of farmers want vets to ask questions to elicit their needs. Frequently mentioned barriers were 'lack of veterinary knowledge of our system', 'not enough cost-benefit of veterinary involvement' and 'we get our fertility information elsewhere'. Along with clinical ability and being approachable, 'understanding our system' and being 'proactive' were qualities participants most valued in a vet. After cost, 'pushing sales and interventions' were the least liked. CONCLUSION: Findings highlight the critical importance of clearly demonstrating the full cost-benefit of veterinary services to farmers. The results contain many details concerning farmer perceptions and values that can help veterinary businesses to strengthen existing services and develop new services.

Understanding doctors' emergency department antibiotic prescribing decisions in children with respiratory symptoms in the UK: a qualitative study.

OBJECTIVE: Exploration of the factors that influence hospital doctors' antibiotic prescribing decisions when treating children with respiratory symptoms in UK emergency departments. METHODS: A qualitative study using semistructured interviews based on a critical incident technique with 21 physicians of different grades and specialties that treat children in the UK. Interviews were audio-recorded then transcribed verbatim and analysed using thematic analysis. RESULTS: Four themes were identified. These themes illustrate factors which influence clinician prescribing. The three principal themes were authorities, pressures and risk. The fourth transcending theme that ran through all themes was clinician awareness and complicity ('knowing but still doing'). CONCLUSIONS: Hospital doctors prescribe antibiotics even when they know they should not. This appears to be due to the influence of those in charge or external pressures experienced while weighing up the immediate and longer term risks but clinicians do this with full insight into their actions. These findings have implications for invested parties seeking to develop future antimicrobial stewardship programmes. It is recommended that stewardship interventions acknowledge and target these themes which may in turn facilitate behaviour change and antimicrobial prescribing practice in emergency departments.

Motivations and Barriers for Veterinarians When Facilitating Fertility Management on UK Dairy Farms.

It is economically essential, but challenging, for dairy farmers to manage bovine fertility. Vets can help farmers to improve fertility, and this is cost-effective bringing benefits for production, animal health and welfare, and the environment. However, the extent to which vets are involved in fertility varies considerably between farms, for reasons that are unclear. This study investigated the motivators and barriers that vets perceive when trying to increase their involvement with fertility management on UK dairy farms. Interviews were conducted with 20 vets and four themes identified. The first, "clinical baggage," highlighted vets' disillusionment due to past experiences of low uptake of their advice by farmers. Consequently, some vets made assumptions about farmer needs and behaviours, and exhibited ageist stereotyping. These issues, along with concerns and fatigue associated with repeatedly offering the same advice which was not acted upon, negatively influenced vets' engagement with farmers. The second theme "stuck in the comfort zone" revealed a loss of enthusiasm by some senior vets, whilst others lacked confidence to engage due to perceived gaps in their knowledge. Vets also reported farmers not perceiving their problems and lack of farm data or facilities, as barriers. The "vet-farmer relationship" theme highlighted building trust and developing strong relationships which were key drivers for vets to proactively engage and to "go the extra mile" for their clients. The final theme "money matters" explored vets' motivations to improve their clients' profitability and included the future sustainability of their own businesses. Our themes provide useful insight into the challenges vets face and provide key areas that can be targeted in future interventions to improve veterinary involvement in fertility management. For example, post-graduate training and support for vets needs to consider factors such as reflection, mentorship, stereotyping, relationships, communication, and leadership skills. This type of postgraduate support is currently limited for vets and requires investment from stakeholders if improvements in production, animal health and welfare, and the environment are to be achieved. Our findings are informative for facilitating veterinary involvement in any disease context, and are relevant for stakeholders including governments, educators, charities, farmer representatives, environmentalists, and veterinary leaders.

Lameness in Beef Cattle: A Cross-Sectional Descriptive Survey of On-Farm Practices and Approaches.

Cattle lameness is a concern to the United Kingdom (UK) cattle industry, negatively impacting upon welfare and production. Previous work involving one small study (n = 21) has identified that some UK beef farmers underestimate lameness prevalence, but also that farmers vary in their perception of the impact of lameness. Knowledge and skills of farmers were identified as a potential concern, and farmer-reported barriers were identified. However, the extent to which these views can be extrapolated is unknown. Therefore, the aim of this study was to produce descriptive results of UK beef farmer lameness-related activities concerning lameness identification, examination, treatment, and prevention. Questionnaires were circulated online and via post. Postal questionnaires were sent to registered Approved Finishing Units (a specific cohort of beef fattening units subject to strict biosecurity measures as part of UK bovine tuberculosis control) and a stratified sample of all registered beef enterprises in England and Wales. Online questionnaires were circulated on social media and via targeted emails asking selected industry bodies and veterinary practices to distribute to farmers. Descriptive results were produced, and thematic analysis was performed on free text responses. There were 532 usable responses, with most farmers self-reporting their current lameness prevalence as zero (mean 1.2%, range 0-20%). Most respondents did not locomotion score cattle, and most reported that it was not safe to examine feet. Most farmers did not use a foot bath, but of those who did, formaldehyde was the most commonly used product. Some farmers reported use of antibiotic foot baths. Most farmers reported dealing with lame animals within 48 h, but some only dealt with severe cases, and some felt that lame animals would get better by themselves. To deal with animals that have an ongoing lameness problem, transportation to slaughter was considered an option by 35% of farmers. It is worth noting, however, that the majority of lame animals would be precluded from transport under UK legislation. Farmers reported staff shortages, as well as a lack of time, training, and knowledge as barriers to lameness prevention and control. Overall, these results suggest that farmers may be underestimating lameness. Diagnosis is likely to be challenging, with unsafe facilities for lifting feet. The reported high threshold by some farmers for attending to a lame animal is a cause for concern, negatively impacting upon animal welfare, but this is also likely to have negative consequences for animal performance and farm profitability. Many participants in this study expressed a desire for farmer training in several aspects relating to lameness prevention and control, and this represents an opportunity for further knowledge exchange regarding lameness in beef cattle.

Reliability of a beef cattle locomotion scoring system for use in clinical practice.

BACKGROUND: Locomotion (lameness) scoring has been used and studied in the dairy industry; however, to the authors' knowledge, there are no studies assessing the reliability of locomotion scoring systems when used with beef cattle. METHODS: A four-point scoring system was developed and beef cattle filmed walking on a firm surface. Eight veterinary researchers, eight clinicians and eight veterinary students were shown written descriptors of the scoring system and four video clips for training purposes, before being asked to score 40 video clips in a random order. Participants repeated this task 4 days later. RESULTS: The intra-observer agreement (the same person scoring on different days) was acceptable with weighted mean Kappa values of 0.84, 0.81 and 0.84 respectively for researchers, clinicians and students. The inter-observer agreement (different people scoring the same animal) was acceptable with weighted Gwet's Agreement Coefficient values of 0.70, 0.69 and 0.64 for researchers, clinicians and students. Most disagreement occurred over scores one (not lame but imperfect locomotion) and two (lame, but not severe). CONCLUSION: This scoring system has the potential to reliably score lameness in beef cattle and help facilitate lameness treatment and control; however, some disagreements will occur especially over scores one and two.

Lameness in Beef Cattle: UK Farmers' Perceptions, Knowledge, Barriers, and Approaches to Treatment and Control.

Lameness in the beef industry has received little attention in the UK, despite the fact that it is a well-recognised problem in the dairy industry. The aims of this study were to (i) compare UK beef farmers' estimates of lameness prevalence to that of researchers, (ii) explore beef farmers' attitudes towards lameness, and (iii) help identify farmer reported barriers to lameness control and treatment. Beef farmers (11 finishing units and 10 suckler farms) were recruited from England and Wales. Farmers were asked to estimate their lameness prevalence, before a researcher conducted locomotion scoring using a five point scale, and a Bland Altman analysis performed. Face to face interviews were also conducted using a semi structured interview script aimed at capturing information such as current approaches and protocols as well as their views of lameness importance. Interviews were recorded and transcribed. An inductive thematic analysis was performed. All but two farmers underestimated lameness prevalence on their farms when compared to the researcher. Farmers initially underestimated lameness prevalence compared to the researchers estimates, with a mean underestimate of 7% (95% CI 5-9%). This is an important barrier to lameness detection and treatment. Thematic analysis identified four major themes: (1). Perception of lameness prevalence, (2). Technical knowledge and skills, (3). Perception of the impact of lameness, and (4). Barriers to the treatment and control of lameness. This study highlights that some approaches to lameness treatment are likely to be causing harm, despite being done with the intention to help the animal. There were four key areas of concern identified: recognition of lameness, treatment approaches, the training provided to farmers and confusion over transport and slaughter options available to farmers. This suggests an urgent need for future work to quantify and address the problem, and to provide evidence to justify the role of prevention and potentially start to break down barriers to control and treatment of lameness.