To report or not to report: a psychosocial investigation aimed at improving early detection of avian influenza outbreaks.

The aim of this study was to identify difficulties and barriers to reporting clinically suspect situations, possibly caused by avian influenza (AI), and to explore possible incentives to reporting such situations, with the ultimate aim of facilitating early detection of AI outbreaks. Focus group sessions were held with policy-makers from the competent authority, representatives of veterinary practitioners and poultry farmers. Personal interviews with a group of poultry farmers and practitioners were held to ascertain the difficulties and barriers they perceived and their proposed solutions. An electronic questionnaire was put on the websites of a poultry farmer union and the Royal Dutch Veterinary Association to investigate perceptions and attitudes concerning AI-suspect situations in The Netherlands. Six themes emerged identifying factors that hinder the reporting of a clinically suspect situation: lack of knowledge and uncertainty about clinical signs of AI; guilt, shame and prejudice; negative opinion of control measures; dissatisfaction with post-reporting procedures; lack of trust in veterinary authorities; lack of transparency in reporting procedures and uncertainty about the notification process. Recommendations to facilitate early detection of AI are discussed.

A socio-psychological investigation into limitations and incentives concerning reporting a clinically suspect situation aimed at improving early detection of classical swine fever outbreaks.

The aim of this study was to identify limitations and incentives in reporting clinically suspect situations, possibly caused by classical swine fever (CSF), to veterinary authorities with the ultimate aim to facilitate early detection of CSF outbreaks. Focus group sessions were held with policy makers from the veterinary authorities, and representatives of veterinary practitioners and pig farmer unions. Personal interviews with a small group of pig farmers and practitioners were held to check limitations raised and solutions proposed during the focus group sessions. An electronic questionnaire was mailed to pig farmers and practitioners to investigate perceptions and attitudes with respect to clinically suspect situations possibly caused by CSF. After triangulating the responses of veterinary authorities, veterinary practitioners and farmers, six themes emerged across all groups: (1) lack of knowledge on the early signs of CSF; (2) guilt, shame and prejudice; (3) negative opinion on control measures; (4) dissatisfaction with post-reporting procedures; (5) lack of trust in government bodies; (6) uncertainty and lack of transparency of reporting procedures. The following solutions to facilitate early detection of CSF were put forward: (a) development of a clinical decision-support system for vets and farmers, in order to get faster diagnosis and detection of CSF; (b) possibility to submit blood samples directly to the reference laboratory to exclude CSF in a clinical situation with non-specific clinical signs, without isolation of the farm and free of charge for the individual farmer; (c) decrease social and economic consequences of reporting CSF, for example by improving the public opinion on first reports; (d) better schooling of veterinary officers to deal with emotions and insecurity of farmers in the process after reporting; (e) better communication of rules and regulations, where to report, what will happen next; (f) up-to-date website with information and visual material of the clinical signs of CSF.

[Nonspecific clinical signs in pigs and use of exclusion diagnosis for classical swine fever: a survey among pig farmers and veterinary practitioners]. / Toepassing van uitsluitdiagnostiek voor klassieke varkenspest bij aspecifieke klinische problemen op varkensbedrijven: een enquête onder varkenshouders en dierenartsen.

Outbreaks of Classical Swine Fever (CSF) occurred in spring 2006 in Germany close to the Dutch border. On 6th April Dutch pig farmers were given the possibility to submit blood samples directly via their veterinary practitioner to the National Reference Laboratory for CSF if their pigs had non-specific clinical symptoms or if pigs were being treated with antibiotics. The pig farm was not quarantined and was not visited by the veterinary authorities. Over a period of 9 weeks 156 pig farmers submitted whole blood samples via 50 different veterinary practices. All samples tested negative in the PCR test. These pig farmers and veterinary practitioners were asked to respond to a postal questionnaire with questions regarding their experience with this new diagnostic possibility, the distribution of the costs involved, a comparison with other instruments, such as official notification or use of a leukocyte count test, and their knowledge of clinical signs of CSF. 65 pig farmers (42%) and 33 veterinary practices (66%) returned the questionnaire. The main results indicated that pig farmers (72%) would use this type of exclusion diagnostics sooner than that they would approach the veterinary authorities (practitioners: 86%). Moreover the respondents considered the fact that the farm was not quarantined immediately to be an advantage (pig farmers, 79%; practitioners, 88%). 32 percent of the pig farmers were not aware that they were required to submit blood samples if pigs were being treated with antibiotics (practitioners: 11%). The majority of pig farmers and practitioners were not satisfied with the current distribution of the costs involved: in their opinion the costs of the PCR test, the costs of the veterinary practitioner and the costs for shipping the samples to the reference laboratory should be paid out of the Animal Health Fund (50% government and 50% industry) or by the government. If the current distribution of the costs is not changed, a large proportion of the pig farmers indicated that they would not use this form of exclusion diagnostics for CSF in the future. Pig farmers appeared to have a rather limited knowledge of the clinical signs of CSF: 33% of the pig farmers could mention maximally three clinical signs of CSF, and 7% could not mention a single clinical sign of CSF and said they were entirely dependent on the practitioners' ability to judge a CSF-suspect situation.

Financial problems and health complaints among farm couples: results of a 10-year follow-up study.

Over a 10-year period, this survey study of 91 Dutch dairy farm couples investigated both causal and reversed causal relationships between couples' financial problems and husbands' and wives' mental and physical health complaints, as well as crossover effects of mental and physical health complaints between spouses. These relationships were tested simultaneously using structural equation modeling analyses. Results showed that financial problems were not predictive of health complaints for either spouse but that husbands' health complaints did predict both couples' financial problems and wives' health complaints 10 years later. These findings emphasize the importance of mental and physical health as resources for both the business and the family. For wives, these effects were not found, which may reflect the different positions of husbands and wives at the farm and, hence, the different ways they allocate their resources.