'I Believe What I'm Saying More Than the Test': The Complicated Place of Rapid, Point-of-Care Tests in Veterinary Diagnostic Practice.

Antimicrobial resistance (AMR) is a global health and development threat, with calls for the optimisation of antimicrobial use (AMU) in the treatment of both humans and animals prevalent across national and international policy. Rapid, low-cost and readily available diagnostics that specifically identify pathogens and their antimicrobial susceptibility profiles have been identified as essential parts of this optimisation process, yet questions over the assumed utility of novel rapid technology as a cornerstone of tackling agricultural AMU still exist. To understand whether this technology may support the optimisation of AMU in the treatment of animal disease, this study qualitatively examines the discourse between veterinarians, laboratory representatives, veterinary researchers and (cattle) farmers within three participatory events concerning diagnostic testing on UK farms, to offer a critical examination of the interaction between veterinary diagnostic practice and agricultural AMU. Veterinarian-led discussion suggested that veterinary rationales for engaging with diagnostic testing are nuanced and complex, where veterinarians (i) were driven by both medical and non-medical motivators; (ii) had a complex professional identity influencing diagnostic-test engagement; and (iii) balanced a multitude of situated contextual factors that informed "gut feelings" on test choice and interpretation. In consequence, it is suggested that data-driven diagnostic technologies may be more palatable for veterinarians to promote to their farm clients in the pursuit of better and more sustainable AMU, whilst also being in synergy with the emerging preventative role of the farm veterinarian.

Influence on the implementation of biosecurity measures in dairy cattle farms: Communication between veterinarians and dairy farmers.

This study was carried out in two regions in Spain (Catalonia and Galicia) through eight focus groups; four for dairy farmers and four for veterinarians. The results showed that dairy farmers and veterinarians attributed responsibility to one another for not following biosecurity practices. The study brings to light contradictions among veterinarians and certain individual veterinary practices that participated in the study, which lead to doubt and confusion on the part of dairy farmers. Distinct perceptions were also identified of the role that government authorities should play in relation both to training and sanctions as a means of improving biosecurity on dairy farms. Additionally, the participants expressed varying opinions as to whether biosecurity measures ought to be made mandatory or remain voluntary. Results from this study highlight the need to promote initiatives through which distinct stakeholders such as veterinarians, government authorities, and dairy farmers can develop consensus-based messages on the implementation of biosecurity practices.

One Health drivers of antibacterial resistance: Quantifying the relative impacts of human, animal and environmental use and transmission.

OBJECTIVES: Antibacterial resistance (ABR) is a major global health security threat, with a disproportionate burden on lower-and middle-income countries (LMICs). It is not understood how 'One Health', where human health is co-dependent on animal health and the environment, might impact the burden of ABR in LMICs. Thailand's 2017 "National Strategic Plan on Antimicrobial Resistance" (NSP-AMR) aims to reduce AMR morbidity by 50% through 20% reductions in human and 30% in animal antibacterial use (ABU). There is a need to understand the implications of such a plan within a One Health perspective. METHODS: A model of ABU, gut colonisation with extended-spectrum beta-lactamase (ESBL)-producing bacteria and transmission was calibrated using estimates of the prevalence of ESBL-producing bacteria in Thailand. This model was used to project the reduction in human ABR over 20 years (2020-2040) for each One Health driver, including individual transmission rates between humans, animals and the environment, and to estimate the long-term impact of the NSP-AMR intervention. RESULTS: The model predicts that human ABU was the most important factor in reducing the colonisation of humans with resistant bacteria (maximum 65.7-99.7% reduction). The NSP-AMR is projected to reduce human colonisation by 6.0-18.8%, with more ambitious targets (30% reductions in human ABU) increasing this to 8.5-24.9%. CONCLUSIONS: Our model provides a simple framework to explain the mechanisms underpinning ABR, suggesting that future interventions targeting the simultaneous reduction of transmission and ABU would help to control ABR more effectively in Thailand.

A participatory, farmer-led approach to changing practices around antimicrobial use on UK farms.

Farmer-led, participatory approaches are being increasingly employed in agricultural research, with promising results. This study aimed to understand how a participatory approach based on the Danish stable schools could help to achieve practical, farmer-led changes that reduced reliance on antimicrobials in the UK. Five facilitated farmer action groups comprising 30 dairy farms across South West England met on farm at regular intervals between 2016 and 2018, and worked collaboratively within their groups to discuss how to reduce antimicrobial use. Qualitative data from group discussions and individual semi-structured interviews were collected and analyzed using thematic analysis to explore how the approach helped farmers address and deal with changes to their on-farm practices. Facilitator-guided reviews of antimicrobial use and benchmarking were carried out on each farm to assess any change in usage and help farmers review their practices. The pattern of antimicrobial use changed over the 2 yr of the study, with 21 participating farms reducing their use of highest-priority critically important antibiotics (6 farms were not using any of these critical medicines from the outset). Thirty practical action plans were co-developed by the groups with an average implementation rate of 54.3% within a year. All assessed farms implemented 1 recommendation, and many were still ongoing at the end of the study. Farmers particularly valued the peer-to-peer learning during farm walks. Farmers reported how facilitated discussions and action planning as a peer group had empowered them to change practices. Participants identified knowledge gaps during the project, particularly on highest-priority critically important antibiotics, where they were not getting information from their veterinarians. The study demonstrated that facilitation has a valuable role to play in participatory approaches beyond moderating discussion; facilitators encouraged knowledge mobilization within the groups and were participants in the research as well. Facilitated, farmer-led, participatory approaches that mobilize different forms of knowledge and encourage peer learning are a promising way of helping farmers to adapt and develop responsible practices.

Veterinary Diagnostic Practice and the Use of Rapid Tests in Antimicrobial Stewardship on UK Livestock Farms.

In this paper we consider the shifting role, practice and context of veterinary diagnosis in addressing concerns over what is, in the context of the growing threat of antimicrobial resistance, considered unnecessary or excessive antimicrobial medicine use in UK livestock farms. With increasing policy and regulatory interest in diagnostic practices and technologies, coupled with an expanding focus on the development and deployment of new rapid and point-of-care on-farm diagnostic testing, this paper investigates current diagnostic practices amongst veterinarians working on dairy, pig and poultry farms in Great Britain (England, Wales, and Scotland) and, more specifically, veterinarians' use and perceptions of new and emerging rapid and point-of-care diagnostic tests. Drawing on a series of 30 semi-structured interviews with farm animal veterinary professionals across the three sectors, this paper examines the manner in which such tests are both used and anticipated in clinical farm animal veterinary practice and the possible impact rapid test technologies might have on broader farm animal health management and disease control. Analysis of the transcribed interviews reveals a number of complexities around the use of rapid and point-of-care diagnostic tests. The relative rapidity and simplification of such tests, facilitating immediate treatment responses, is held in balance against both the accuracy and the more detailed and documented procedures of established laboratory testing routes. In situations of multifaceted on-farm etiologies, respondents maintained that rapid tests may offer restricted diagnostic capabilities, though in other situations they were found to offer ready confirmation of disease presence. A third complexity arising from the growth of rapid and point-of-care testing and revealed in this study relates to the shifting distribution of responsibilities in animal health care within contemporary food chains. The growing availability of rapid and point-of-care tests effectively diversifies the range of diagnostic actors with consequences for the flow of diagnostic and disease information. The veterinarians in this study identified areas where new rapid and point-of-care tests would be of particular value to them in their clinical practice particularly in addressing concerns over inappropriate antimicrobial use in animal treatment. However, despite the considerable policy advocacy on rapid and point-of-care tests as key tools in shifting diagnostic practice and reducing unnecessary antimicrobial use, veterinarians in this study, while recognizing the potential future role of such tools and technologies, nonetheless viewed diagnostic practice as a far more complex process for which rapid tests might constitute only a part.

Animal Welfare Management in a Digital World.

Although there now exists a wide range of policies, instruments and regulations, in Europe and increasingly beyond, to improve and safeguard the welfare of farmed animals, there remain persistent and significant welfare issues in virtually all types of animal production systems ranging from high prevalence of lameness to limited possibilities to express natural behaviours. Protocols and indicators, such as those provided by Welfare Quality, mean that animal welfare can nowadays be regularly measured and surveyed at the farm level. However, the digital revolution in agriculture opens possibilities to quantify animal welfare using multiple sensors and data analytics. This allows daily monitoring of animal welfare at the group and individual animal level, for example, by measuring changes in behaviour patterns or physiological parameters. The present paper explores the potential for developing innovations in digital technologies to improve the management of animal welfare at the farm, during transport or at slaughter. We conclude that the innovations in Precision Livestock Farming (PLF) offer significant opportunities for a more holistic, evidence-based approach to the monitoring and surveillance of farmed animal welfare. To date, the emphasis in much PLF technologies has been on animal health and productivity. This paper argues that this emphasis should not come to define welfare. What is now needed is a coming together of industry, scientists, food chain actors, policy-makers and NGOs to develop and use the promise of PLF for the creative and effective improvement of farmed animal welfare.

Diagnostics and the challenge of antimicrobial resistance: a survey of UK livestock veterinarians' perceptions and practices.

BACKGROUND: This paper explores the current role and place of diagnostic tests in the treatment of farm animal disease. With the growing focus on reduced reliance on antibiotic medicines in both animal and human patient care, attention is increasingly being focused on the practice, the technology and the function of diagnostic tests and how these can support responsible antimicrobial use. Emerging diagnostic technologies offer the possibility of more rapid testing for bacterial disease, while food chain actors and others are increasingly seeking to make diagnostic tests mandatory before the use of critically important antibiotics. METHOD: This paper reports the findings of a recent large-scale online survey of UK farm animal veterinarians (n=153) which investigated current veterinary diagnostic practice with particular attention to the relationship between diagnostic test use and antibiotic treatment. RESULTS: Results revealed a range of factors that influence veterinary diagnostic practice and demonstrate the continuing importance of clinical observation and animal/herd knowledge in the selection of antibiotic treatment. CONCLUSION: The findings identify a considerable ambivalence on the part of farm animal veterinarians regarding the current and future uses of rapid and point-of-care diagnostic tests as a means of improving clinical diagnosis and addressing inappropriate antibiotic medicine use.

Understanding the Attitudes of Communities to the Social, Economic, and Cultural Importance of Working Donkeys in Rural, Peri-urban, and Urban Areas of Ethiopia.

Working donkeys (Equus africanus asinus) are vital to the development and support of people's livelihoods in rural, peri-urban, and urban areas of Ethiopia. However, despite their critical role in providing transport, food security, and income generation to some of the poorest and most marginalized households, donkey contributions to human livelihoods have been largely unexplored. Donkey users, veterinary surgeons, business owners, and civil servants were interviewed to investigate the role humans play in shaping donkey lives while furthering our understanding of the social and economic impacts of working donkeys to human lives. Findings are discussed through seven guiding themes; donkeys as generators of income, the relationship between donkeys and social status, donkeys and affect, empowerment through donkeys, the role of donkeys in reducing vulnerability and encouraging resilience, donkey husbandry, and gender dynamics all of which gave a broader and richer insight into the value of donkeys. Donkeys are an important support in rural, peri-urban, and urban settings through the creation of economic security, independence, and participation in local saving schemes. In addition, donkeys provide social status, empowerment to marginalized groups such as women and the very poor and provide a sense of companionship. Whether the interviewee was a donkey user or a key informant appeared to influence their views on donkeys and their welfare, as did their location. The variations in views and practices between urban and rural settings suggests that assessing the socioeconomic value of donkeys in different locations within the same area or country is critical, rather than assuming that similar views are held between compatriots. Despite their centrality to many people's lives in Ethiopia, working donkeys often hold lowly status, are misunderstood, and given little husbandry and healthcare.

HENNOVATION: Learnings from Promoting Practice-Led Multi-Actor Innovation Networks to Address Complex Animal Welfare Challenges within the Laying Hen Industry.

The Hennovation project, an EU H2020 funded thematic network, aimed to explore the potential value of practice-led multi-actor innovation networks within the laying hen industry. The project proposed that husbandry solutions can be practice-led and effectively supported to achieve durable gains in sustainability and animal welfare. It encouraged a move away from the traditional model of science providing solutions for practice, towards a collaborative approach where expertise from science and practice were equally valued. During the 32-month project, the team facilitated 19 multi-actor networks in five countries through six critical steps in the innovation process: problem identification, generation of ideas, planning, small scale trials, implementation and sharing with others. The networks included farmers, processors, veterinarians, technical advisors, market representatives and scientists. The interaction between the farmers and the other network actors, including scientists, was essential for farmer innovation. New relationships emerged between the scientists and farmers, based on experimental learning and the co-production of knowledge for improving laying hen welfare. The project demonstrated that a practice-led approach can be a major stimulus for innovation with several networks generating novel ideas and testing them in their commercial context. The Hennovation innovation networks not only contributed to bridging the science-practice gap by application of existing scientific solutions in practice but more so by jointly finding new solutions. Successful multi-actor, practice-led innovation networks appeared to depend upon the following key factors: active participation from relevant actors, professional facilitation, moderate resource support and access to relevant expertise. Farmers and processors involved in the project were often very enthusiastic about the approach, committing significant time to the network's activities. It is suggested that the agricultural research community and funding agencies should place greater value on practice-led multi-actor innovation networks alongside technology and advisor focused initiatives to improve animal welfare and embed best practices.

Storage of prescription veterinary medicines on UK dairy farms: a cross-sectional study.

Prescription veterinary medicine (PVM) use in the UK is an area of increasing focus for the veterinary profession. While many studies measure antimicrobial use on dairy farms, none report the quantity of antimicrobials stored on farms, nor the ways in which they are stored. The majority of PVM treatments occur in the absence of the prescribing veterinarian, yet there is an identifiable knowledge gap surrounding PVM use and farmer decision making. To provide an evidence base for future work on PVM use, data were collected from 27 dairy farms in England and Wales in Autumn 2016. The number of different PVMs stored on farms ranged from 9 to 35, with antimicrobials being the most common therapeutic group stored. Injectable antimicrobials comprised the greatest weight of active ingredient found, while intramammary antimicrobials were the most frequent unit of medicine stored. Antimicrobials classed by the European Medicines Agency as critically important to human health were present on most farms, and the presence of expired medicines and medicines not licensed for use in dairy cattle was also common. The medicine resources available to farmers are likely to influence their treatment decisions; therefore, evidence of the PVM stored on farms can help inform understanding of medicine use.

Towards Farm Animal Welfare and Sustainability.

As farm animal welfare becomes an increasingly important component of contemporary global livestock production, animal welfare science and animal welfare policy-making need to find new ways of entering global debates over food security and sustainability. In this paper, we explore the means by which both animal welfare science and policy should articulate with these emerging global debates. Having first established the important gains in animal welfare policy and the maturity of animal welfare science, we identify and explore the potential impact of these current debates and argue that they have the potential for profound change in our understanding of, and our response to, the welfare of animals. We conclude the paper with a number of possible recommendations for how a scientifically informed, sustainable animal welfare policy might flourish.

Antimicrobial use in food-producing animals: a rapid evidence assessment of stakeholder practices and beliefs.

Food-producing animals throughout the world are likely to be exposed to antimicrobial (AM) treatment. The crossover in AM use between human and veterinary medicine raises concerns that antimicrobial resistance (AMR) may spread from food-producing animals to humans, driving the need for further understanding of how AMs are used in livestock practice as well as stakeholder beliefs relating to their use. A rapid evidence assessment (REA) was used to collate research on AM use published in peer-reviewed journals between 2000 and 2016. Forty-eight papers were identified and reviewed. The summary of findings highlights a number of issues regarding current knowledge of the use of AMs in food-producing animals and explores the attitudes of interested parties regarding the reduction of AM use in livestock. Variation between and within countries, production types and individual farms demonstrates the complexity of the challenge involved in monitoring and regulating AM use in animal agriculture. Many factors that could influence the prevalence of AMR in livestock are of concern across all sections of the livestock industry. This REA highlights the potential role of farmers and veterinarians and of other advisors, public pressure and legislation to influence change in the use of AMs in livestock.

Equine Welfare Assessment: Exploration of British Stakeholder Attitudes Using Focus-Group Discussions.

The equine industry in Great Britain has not been subject to the same pressures as the farming industry to engage with welfare assessment, but this may change as concern about equine welfare increases. Stakeholder attitudes toward welfare assessment may impact the implementation of welfare assessment practices. Focus-group discussions regarding welfare assessment were conducted with 6 equine stakeholder groups: leisure horse owners (caregivers; n = 4), grooms (n = 5), veterinary surgeons (n = 3), welfare scientists (n = 4), welfare charity workers (n = 5), and professional riders (n = 4). Three themes emerged from the discussions: (a) Participants predominantly interpreted welfare assessment as a means of identifying and correcting poor welfare in an immediate way; (b) participants believed that horse welfare varied over time; and (c) attributes of the assessor were viewed as an important consideration for equine welfare assessment. The views of equine industry members give insight into the value welfare assessments may have to the industry and how equine welfare assessment approaches can achieve credibility within the industry and increase the positive impact of welfare assessments on equine welfare.

Equine Welfare in England and Wales: Exploration of Stakeholders' Understanding.

Investigating how those responsible for the care of nonhuman animals understand the concept of animal welfare is important for animal welfare improvement. In-depth interviews with 31 equine stakeholders were used to explore their perceptions and understanding of welfare. The results showed the stakeholders understood the concept of welfare in 4 ways. Firstly, welfare was understood in terms of the provision of resources-for example, food. Secondly, a "horse-centered" understanding of welfare was articulated; this understanding included the horses' mental state and was linked to natural behavior. Thirdly, the word welfare had negative connotations, and for some, good welfare was achieved through avoidance of negative states. Finally, interviewees discussed incidents that occurred in their own familiar contexts but suggested that these were not welfare problems. Evidence indicated that the ways in which equine stakeholders understood the concept of welfare might have been acting as a barrier to the alleviation of some equine welfare problems. There is a need for strategies aimed at improving equine welfare to consider stakeholder constructs of welfare and the ways in which these constructs are generated and acted upon.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders.

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively.

Developing a Collaborative Agenda for Humanities and Social Scientific Research on Laboratory Animal Science and Welfare.

Improving laboratory animal science and welfare requires both new scientific research and insights from research in the humanities and social sciences. Whilst scientific research provides evidence to replace, reduce and refine procedures involving laboratory animals (the '3Rs'), work in the humanities and social sciences can help understand the social, economic and cultural processes that enhance or impede humane ways of knowing and working with laboratory animals. However, communication across these disciplinary perspectives is currently limited, and they design research programmes, generate results, engage users, and seek to influence policy in different ways. To facilitate dialogue and future research at this interface, we convened an interdisciplinary group of 45 life scientists, social scientists, humanities scholars, non-governmental organisations and policy-makers to generate a collaborative research agenda. This drew on methods employed by other agenda-setting exercises in science policy, using a collaborative and deliberative approach for the identification of research priorities. Participants were recruited from across the community, invited to submit research questions and vote on their priorities. They then met at an interactive workshop in the UK, discussed all 136 questions submitted, and collectively defined the 30 most important issues for the group. The output is a collaborative future agenda for research in the humanities and social sciences on laboratory animal science and welfare. The questions indicate a demand for new research in the humanities and social sciences to inform emerging discussions and priorities on the governance and practice of laboratory animal research, including on issues around: international harmonisation, openness and public engagement, 'cultures of care', harm-benefit analysis and the future of the 3Rs. The process outlined below underlines the value of interdisciplinary exchange for improving communication across different research cultures and identifies ways of enhancing the effectiveness of future research at the interface between the humanities, social sciences, science and science policy.

Livestock Production in the UK in the 21(st) Century: A Perfect Storm Averted?

There is a school of thought that future demand for meat and other farm animal products is unsustainable for several reasons, including greenhouse gas emissions, especially from ruminants; standards of farm animal health and welfare, especially when farm animals are kept intensively; efficiency of conversion by livestock of solar energy into (human) food, particularly by pigs and poultry; water availability and usage for all types of agricultural production, including livestock; and human health and consumption of meat, eggs and milk. Demand for meat is forecast to rise as a result of global population growth and increasing affluence. These issues buttress an impending perfect storm of food shortages, scarce water and insufficient energy, which is likely to coincide with global population reaching about 9 billion people in 2030 (pace Beddington). This paper examines global demand for animal products, the narrative of 'sustainable intensification' and the implications of each for the future of farm animal welfare. In the UK, we suggest that, though non-ruminant farming may become unsustainable, ruminant agriculture will continue to prosper because cows, sheep and goats utilize grass and other herbage that cannot be consumed directly by humans, especially on land that is unsuitable for other purposes. However, the demand for meat and other livestock-based food is often for pork, eggs and chicken from grain-fed pigs and poultry. The consequences of such a perfect storm are beginning to be incorporated in long-term business planning by retailers and others. Nevertheless, marketing sustainable animal produce will require considerable innovation and flair in public and private policies if marketing messages are to be optimized and consumer behaviour modified.