Search

Introduction: Clinical mastitis (CM) treatment decision-making is a multifaceted process that remains relatively understudied, despite CM being one of the most prevalent diseases on dairy farms worldwide, contributing greatly to the use of antimicrobials in the dairy industry. This study aimed to gain insights into decision-making mechanisms employed by dairy farmers in British Columbia and Alberta, Canada, when dealing with CM., Methods: Interviews were held with 15 dairy farmers in the Canadian provinces of British Columbia and Alberta and analyzed using reflexive thematic analysis to develop both the decision-pathway and overarching themes influencing the CM decisions by farmers in this region., Results and Discussion: The analysis generated a decision-making process that begins with identification and classification of CM, guided by visual characteristics of milk and the udder, available milk production and quality data, presence of systemic signs, and additional diagnostics. Subsequently, CM cases are assessed based on the likelihood of cure, value of the cow, and herd goals to decide whether antimicrobial treatment is desired. Next, a treatment choice is made by evaluating severity and urgency of the case, availability of drugs and timing of the case. Finally, definition of treatment success and progression over time following the treatment decision guides the termination of treatment. Three overarching themes were generated that shape the decision-making process: 'Personal attributes', including personal approach and experiential knowledge; 'Inter-actor dynamics', such as shared decision-making and dynamics among producers, veterinarians, and milkers; and 'Moving beyond protocols', which highlights the dynamic nature of mastitis decision-making. These insights have the potential to inform the development of effective interventions to improve CM antimicrobial use that align with the reality of farming operations within Western Canada, and potentially beyond., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 de Jong, van der Velden, Smid, Ida, Reyher, Kelton and Barkema.)

Background: Veterinary practice staff are directly involved in the dispensing of prescription veterinary medicines (POM-Vs) to farmers as prescribed by registered veterinary surgeons to animals 'under their care'. The role of veterinary practice staff has, to date, been underresearched. The objective of this study was to investigate the roles played by veterinary practice staff, exploring their expectations and perceptions of the front-of-house (FoH) role, their interactions with clients in day-to-day veterinary practice and their experiences relating to the dispensing of POM-Vs., Methods: Thematic analysis was used to analyse data from 20 semi-structured interviews of veterinary practice staff. Participants were recruited from 80% of the large animal or mixed species veterinary practices across Wales., Results: Four key themes-'piggy in the middle', learning on the job, practice organisation and facilitating change-were identified, illustrating the multifaceted and diverse nature of this type of employment., Limitations: This study is not intended to be representative of the perceptions of FoH staff on the dispensing of antimicrobials. Larger-scale studies are required to substantiate these findings., Conclusion: Understanding the roles of non-clinical veterinary staff allows practice managers and veterinary surgeons to better identify and meet training and staffing needs and improves recognition of this key area of practice work., (© 2024 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.)

Control measures are being introduced globally to reduce the prevalence of antibiotic resistance (ABR) in bacteria on farms. However, little is known about the current prevalence and molecular ecology of ABR in bacterial species with the potential to be key opportunistic human pathogens, such as Escherichia coli, on South American farms. Working with 30 dairy cattle farms and 40 pig farms across two provinces in central-eastern Argentina, we report a comprehensive genomic analysis of third-generation cephalosporin-resistant (3GC-R) E. coli , which were recovered from 34.8% (cattle) and 47.8% (pigs) of samples from fecally contaminated sites. Phylogenetic analysis revealed substantial diversity suggestive of long-term horizontal and vertical transmission of 3GC-R mechanisms. CTX-M-15 and CTX-M-2 were more often produced by isolates from dairy farms, while CTX-M-8 and CMY-2 and co-carriage of amoxicillin/clavulanate resistance and florfenicol resistance were more common in isolates from pig farms. This suggests different selective pressures for antibiotic use in these two animal types. We identified the β-lactamase gene bla ROB , which has previously only been reported in the family Pasteurellaceae , in 3GC-R E. coli. bla ROB was found alongside a novel florfenicol resistance gene, ydhC , also mobilized from a pig pathogen as part of a new composite transposon. As the first comprehensive genomic survey of 3GC-R E. coli in Argentina, these data set a baseline from which to measure the effects of interventions aimed at reducing on-farm ABR and provide an opportunity to investigate the zoonotic transmission of resistant bacteria in this region., Importance: Little is known about the ecology of critically important antibiotic resistance among bacteria with the potential to be opportunistic human pathogens (e.g., Escherichia coli ) on South American farms. By studying 70 pig and dairy cattle farms in central-eastern Argentina, we identified that third-generation cephalosporin resistance (3GC-R) in E. coli was mediated by mechanisms seen more often in certain species and that 3GC-R pig E. coli were more likely to be co-resistant to florfenicol and amoxicillin/clavulanate. This suggests that on-farm antibiotic usage is key to selecting the types of E. coli present on these farms. 3GC-R E. coli and 3GC-R plasmids were diverse, suggestive of long-term circulation in this region. We identified the de novo mobilization of the resistance gene bla ROB from pig pathogens into E. coli on a novel mobile genetic element, which shows the importance of surveying poorly studied regions for antibiotic resistance that might impact human health., Competing Interests: The authors declare no conflict of interest.

Antimicrobials are essential in veterinary medicine to treat and control bacterial disease in animals. Their prudent use in food-producing animals has been encouraged to reduce the development and spread of antimicrobial resistance. National and international guidelines for responsible antimicrobial use have been developed as tools to guide and rationalise antimicrobial prescribing decisions by veterinarians and usage decisions by farmers. Yet, there is little understanding of whether these existing guidelines are fit for purpose. Accordingly, this study rigorously assessed 128 veterinary guidelines for antimicrobial use in ruminants in the UK, following established qualitative methodologies. Findings revealed four pertinent themes: validation of the veterinarian as the prescriber, visibility of responsible use realities, vagueness in interpretation and variation in directing behaviour. These themes encompassed the roles and responsibilities of the veterinarian and the realities of prescribing scenarios, alongside concerns relating to the specificity within and variation between guidelines. Resultant recommendations to inform and support the future development of guidelines include establishing species-specific and disease-specific guidelines, expanding guidelines to include disease prevention measures, including definitions to resolve vagueness and promoting congruence in interpretation, encouraging the development of practice-level guidelines to endorse collaboration and ownership, and fostering active working between stakeholders to align priorities and messaging., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Best et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Rates of fluoroquinolone resistance in Escherichia coli , a key opportunistic human pathogen, are problematic. Taking a One Health approach, we investigated the excretion of fluoroquinolone-resistant (FQ-R) E. coli by 600 dogs (303 from rural and 297 from urban environments) recruited from a 50 × 50 km region where we have also surveyed FQ-R E. coli from cattle and from human urine. FQ-R E. coli were detected in faeces from 7.3% (rural) and 11.8% (urban) of dogs. FQ-R E. coli from rural dogs tended to be of sequence types (STs) commonly excreted by cattle, whilst those from urban dogs tended to carry plasmid-mediated quinolone resistance genes, common in human E. coli in our study region. Phylogenetic evidence was obtained for sharing FQ-R E. coli - particularly for STs 10, 162 and 744 - between cattle, dogs and humans. Epidemiological analysis showed a strong association between feeding dogs uncooked meat and the excretion of FQ-R E. coli , particularly for STs 10, 162 and 744. This practice, therefore, could serve as a transmission link for FQ-R E. coli from farmed animals entering the home so we suggest that dogs fed uncooked meat should be handled and housed using enhanced hygiene practices., Competing Interests: M.B.A. is married to the owner of a veterinary practice that sells various mass-manufactured dog foods amounting to a value <5% of total turnover. Otherwise, the authors declare no competing interests., (© 2023 The Authors.)

Background: Accurate and reliable assessment of clinician integrity in the delivery of empirically supported treatments is critical to effective research and training interventions. Assessment of clinician integrity can be performed through recording simulated (SI) or real-life (RL) consultations, yet research examining the equivalence of these data is in its infancy. To explore the strength of integrity assessment between SI and RL samples in Motivational Interviewing (MI) consultations, this article examines whether Motivational Interviewing Treatment Integrity (MITI) assessments differ between SI and RL consultations and reviews the predictive validity of SI and RL MI skills categorisations for RL client response language., Methods: This study first compared MITI coding obtained in SI and RL consultations for 36 veterinary clinicians. Multilevel models of 10 MITI behaviour counts and four MITI global scores were run using MLwiN 3.02 to assess if a significant difference existed between SI and RL MITI data, with consultation within clinician within cohort (A and B) as nested random effects. Second, we investigated the effect of SI and RL MI skills groupings on rate of RL client response talk using three multivariable regression models. Two Poisson regression models, with random intercepts for farm and veterinarian and offset for number of minutes of the recordings, were estimated in the statistical software R using the package glmmTMB for the two response variables Change Talk and Sustain Talk. A logistic regression model, with the same random intercepts, with the response variable Proportion Change Talk was also estimated using the same package., Results: Veterinary clinicians were less MI consistent in RL consultations, evidenced through significantly lower global MITI Cultivating Change Talk ( p < 0.001), Partnership ( p < 0.001) and Empathy ( p = 0.003) measures. Despite lower objective MI skills groupings in RL consultations, ranking order of veterinary clinicians by MI skills was similar between contexts. The predictive validity of SI and RL MI skills groupings for RL client Change Talk was therefore similar, with significantly more RL client Change Talk associated with veterinarians categorised in the highest grouping ('moderate') in both SI ( p = 0.01) and RL ( p = 0.02) compared to untrained veterinarians in each respective context., Conclusions: Findings suggest SI and RL data may not be interchangeable. Whilst both data offer useful insights for specific research and training purposes, differing contextual MI skills thresholds may offer a more equitable assessment of clinician RL client-facing MI integrity. Further research is needed to explore the applicability of these findings across health contexts., Competing Interests: Lars Forsberg is Operations Manager at MICLab AB., (© 2023 Bard et al.)

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.

Current veterinary communication skills training often focuses on the strategies necessary to successfully transfer information and promote shared decision making rather than inspiring client motivation to engage in behaviour change(s). One evidence-based communication methodology with a specific focus on enhancing conversations about change is Motivational Interviewing (MI), which is perceived by veterinarians to be highly relevant to their profession. We examined whether veterinarians who experienced brief (4-5 hours) MI training (BMIT) were able to change their communication behaviours to be more MI consistent. Fourteen veterinarians recorded 31 veterinary herd health consultations before (n = 15) and after (n = 16) BMIT to allow pre-post intervention analysis of veterinarian and farmer verbal behaviour. Additionally, using a sequential linguistic analysis of 3885 veterinarian-farmer communication events within these consultations, the influence of veterinarians' verbal behaviours on farmers' response language was explored. Analysis of veterinary consultations undertaken before and after BMIT revealed that veterinarians changed their communication style to be more consistent with the MI methodology, including more use of reflection statements, a more empathic and partnership-oriented consultation style and greater emphasis on clients' own language in favour of change goals. In response, farmers contributed more to the conversation and discussed more herd health-related changes. Sequential linguistic analysis suggested that following a veterinarian emphasising something positive about the farmer (e.g. efforts, strengths), seeking collaboration or emphasising farmer choice, farmers were subsequently more likely to express arguments in favour of change ('Change Talk'), especially phrases indicative of commitment. This study offers the first evidence of the potential value of a BMIT experience to enhance veterinary communication skills, although conscious and disciplined use of MI principles, strategies and Spirit-an ethos of compassion, acceptance, partnership and evocation-requires longer and more complex training. Further studies examining the longevity and consistency of these verbal behaviour changes following BMIT are required., Competing Interests: The authors have declared that no competing interests exist.

Objectives: To compare faecal third-generation cephalosporin-resistant (3GC-R) Escherichia coli isolates from dogs living in a city and in a rural area ∼30 km away; to compare isolates from dogs, cattle and humans in these regions; and to determine risk factors associated with 3GC-R E. coli carriage in these two cohorts of dogs., Methods: Six hundred dogs were included, with faecal samples processed to recover 3GC-R E. coli using 2 mg/L cefotaxime. WGS was by Illumina and risk factor analyses were by multivariable linear regression using the results of an owner-completed survey., Results: 3GC-R E. coli were excreted by 20/303 rural and 31/297 urban dogs. The dominant canine 3GC-R ST was ST963 (blaCMY-2), which also accounted for 25% of CMY-2-producing E. coli in humans. Phylogenetic overlap between cattle and rural dog CTX-M-14-producing E. coli ST117 was observed as well as acquisition of pMOO-32-positive E. coli ST10 by a rural dog, a plasmid common on cattle farms in the area. Feeding raw meat was associated with carrying 3GC-R E. coli in rural dogs, but not in urban dogs, where swimming in rivers was a weak risk factor., Conclusions: Given clear zoonotic potential for resistant canine E. coli, our work suggests interventions that may reduce this threat. In rural dogs, carriage of 3GC-R E. coli, particularly CTX-M producers, was phylogenetically associated with interaction with local cattle and epidemiologically associated with feeding raw meat. In urban dogs, sources of 3GC-R E. coli appear to be more varied and include environments such as rivers., (© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)

Communication has been identified as one constraint for cattle veterinarians to act as proactive health consultants. Motivational Interviewing (MI), an evidence-based client-centered communication methodology, may therefore be a useful tool in veterinary herd health management (VHHM). The aim of this exploratory study was to investigate associations between training in MI and different measures of performance in VHHM. MI skills of 36 Swedish cattle veterinarians randomly assigned to two groups - MI veterinarians (n = 18) who had received six-months training in MI and control veterinarians (n = 18) who were not trained - were assessed using the MI Treatment Integrity coding system. Skills were categorized as untrained, trained&#95;poor, trained&#95;near moderate and trained&#95;moderate. Veterinarians each visited two to six cattle farms for VHHM consultations and revisited the same farms three to six months later to document implementation of recommendations. A gamma model and logistic or ordered logistic regression models were used to evaluate associations between MI training and performance measured as: a) proportion of consultations resulting in written herd health plans, b) proportion of recommended measures fully or partially implemented, c) Likert scores of different estimates of client satisfaction and d) total time during 6 months allocated to VHHM visits on cattle farms. We found no evidence of any significant effects of MI training on the eight performance variables analyzed. However, a pattern of numerically higher values (better performance) in trained veterinarians with poor or moderate MI skills than in untrained veterinarians was observed in most variables. Clients were highly satisfied with veterinarians' attitude, competence and time efficiency. Farms implemented a median of 66.7% (interquartile range: 50-100) of the measures partially or fully. Veterinarians allocated little time to VHHM visits (median: 2.2; interquartile range: 0.65-4.1 h per week of full-time work within cattle). Veterinarians with moderate skills spent 2.14 times more time on VHHM visits than untrained veterinarians, but the confidence interval was wide (0.88-5.21). The pattern of numerically higher values in trained veterinarians supported findings from other studies in the same project indicating a positive effect of MI training on VHHM. Our observations suggest a considerable potential to increase veterinarians' engagement in VHHM., (Copyright © 2022. Published by Elsevier B.V.)

Aims: To investigate whether on-farm antibacterial usage (ABU), environmental antibacterial-resistant (ABR) Escherichia coli prevalence, sampling and sample handling methodologies are associated with ABR E. coli positivity in individual faecal samples from dairy heifers., Methods and Results: Three hundred and sixty-four heifers from 37 farms were sampled via rectal or faecal pat sampling. Samples were stored at -80°C for variable periods before microbiological analysis. Data analysis was done through a multilevel, multivariable logistic regression approach. Individual rectal samples had increased odds of positivity for amoxicillin-, cefalexin- and tetracycline-resistant E. coli. Sample storage for 6-12 months was associated with decreased odds of finding amoxicillin- and tetracycline-resistant E. coli. On-farm ABU had little influence, and environmental ABR E. coli prevalence had no significant influence on the odds of sample-level positivity for ABR E. coli., Conclusions: Sampling methodology and sample handling have a greater association than on-farm factors with the detection of ABR E. coli in individual faecal samples from dairy heifers., Significance and Impact of the Study: Sampling and storage methodologies should be considered carefully at the point of designing ABR surveillance studies in livestock and their environments and, where possible, these methodologies should be standardized between and within future studies., (© 2021 The Authors. Journal of Applied Microbiology published by John Wiley & Sons Ltd on behalf of Society for Applied Microbiology.)

We report a survey (August 2017 to March 2018) and risk factor analysis of faecal carriage of antibacterial-resistant (ABR) Escherichia coli in 223 16-week-old dogs in the United Kingdom. Raw feeding was associated with the presence of fluoroquinolone-resistant (FQ-R) E. coli and those resistant to tetracycline, amoxicillin, and streptomycin, but not to cefalexin. Whole genome sequencing of 36 FQ-R E. coli isolates showed a wide range of sequence types (STs), with almost exclusively mutational FQ-R dominated by ST744 and ST162. Comparisons between E. coli isolates from puppies known to be located within a 50 × 50 km region with those isolated from human urinary tract infections (isolated in parallel in the same region) identified an ST744 FQ-R lineage that was carried by one puppy and caused one urinary tract infection. Accordingly, we conclude that raw feeding is associated with carriage of ABR E. coli in dogs even at 16 weeks of age and that bacteria carried by puppies are shared with humans. We therefore suggest that those who feed their dogs raw meat seriously consider the potential ABR-transmission threat their pet may become as a result and deploy appropriate hygiene practices in mitigation., Competing Interests: M.B.A. is married to the owner of a veterinary practice that sells various mass-manufactured dog foods amounting to a value less than 5% of total turnover. Otherwise, none of the above named authors is declaring any conflict of interest in relation to the above titled submitted manuscript., (© 2022 The Authors.)

Background: Our primary aim was to test whether cattle-associated fluoroquinolone-resistant (FQ-R) Escherichia coli found on dairy farms are closely phylogenetically related to those causing bacteriuria in humans living in the same 50 × 50 km geographical region suggestive of farm-human sharing. Another aim was to identify risk factors for the presence of FQ-R E. coli on dairy farms., Methods: FQ-R E. coli were isolated during 2017-18 from 42 dairy farms and from community urine samples. Forty-two cattle and 489 human urinary isolates were subjected to WGS, allowing phylogenetic comparisons. Risk factors were identified using a Bayesian regularization approach., Results: Of 489 FQ-R human isolates, 255 were also third-generation-cephalosporin-resistant, with strong genetic linkage between aac(6')Ib-cr and blaCTX-M-15. We identified possible farm-human sharing for pairs of ST744 and ST162 isolates, but minimal core genome SNP distances were larger between farm-human pairs of ST744 and ST162 isolates (71 and 63 SNPs, respectively) than between pairs of isolates from different farms (7 and 3 SNPs, respectively). Total farm fluoroquinolone use showed a positive association with the odds of isolating FQ-R E. coli, while total dry cow therapy use showed a negative association., Conclusions: This work suggests that FQ-R E. coli found on dairy farms have a limited impact on community bacteriuria within the local human population. Reducing fluoroquinolone use may reduce the on-farm prevalence of FQ-R E. coli and this reduction may be greater when dry cow therapy is targeted to the ecology of resistant E. coli on the farm., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.)

Antimicrobial use in agriculture has been identified as an area of focus for reducing overall antimicrobial use and improving stewardship. In this paper, we outline the design of a complex antimicrobial stewardship (AMS) intervention aimed at developing a national Veterinary Prescribing Champion programme for Welsh farm animal veterinary practices. We describe the process by which participants were encouraged to design and deliver bespoke individualised AMS activities at practice level by forging participant "champion" identities and communities of practice through participatory and educational online activities. We describe the key phases identified as important when designing this complex intervention, namely (i) involving key collaborators in government and industry to stimulate project engagement; (ii) grounding the design in the literature, the results of stakeholder engagement, expert panel input, and veterinary clinician feedback to promote contextual relevance and appropriateness; and (iii) taking a theoretical approach to implementing intervention design to foster critical psychological needs for participant motivation and scheme involvement. With recruitment of over 80% of all farm animal practices in Wales to the programme, we also describe demographic data of the participating Welsh Veterinary Prescribing Champions in order to inform recruitment and design of future AMS programmes.

Little is known about the drivers of critically important antibacterial resistance in species with zoonotic potential present on farms (e.g., CTX-M β-lactamase-positive Escherichia coli ). We collected samples monthly between January 2017 and December 2018 on 53 dairy farms in South West England, along with data for 610 variables concerning antibacterial usage, management practices, and meteorological factors. We detected E. coli resistant to amoxicillin, ciprofloxacin, streptomycin, and tetracycline in 2,754/4,145 (66%), 263/4,145 (6%), 1,475/4,145 (36%), and 2,874/4,145 (69%), respectively, of samples from fecally contaminated on-farm and near-farm sites. E. coli positive for bla CTX-M were detected in 224/4,145 (5.4%) of samples. Multilevel, multivariable logistic regression showed antibacterial dry cow therapeutic choice (including use of cefquinome or framycetin) to be associated with higher odds of bla CTX-M positivity. Low average monthly ambient temperature was associated with lower odds of bla CTX-M E. coli positivity in samples and with lower odds of finding E. coli resistant to each of the four test antibacterials. This was in addition to the effect of temperature on total E. coli density. Furthermore, samples collected close to calves had higher odds of having E. coli resistant to each antibacterial, as well as E. coli positive for bla CTX-M Samples collected on pastureland had lower odds of having E. coli resistant to amoxicillin or tetracycline, as well as lower odds of being positive for bla CTX-M IMPORTANCE Antibacterial resistance poses a significant threat to human and animal health and global food security. Surveillance for resistance on farms is important for many reasons, including tracking impacts of interventions aimed at reducing the prevalence of resistance. In this longitudinal survey of dairy farm antibacterial resistance, we showed that local temperature-as it changes over the course of a year-was associated with the prevalence of antibacterial-resistant E. coli We also showed that prevalence of resistant E. coli was lower on pastureland and higher in environments inhabited by young animals. These findings have profound implications for routine surveillance and for surveys carried out for research. They provide important evidence that sampling at a single time point and/or single location on a farm is unlikely to be adequate to accurately determine the status of the farm regarding the presence of samples containing resistant E. coli ., (Copyright © 2021 American Society for Microbiology.)

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., (Copyright © 2021 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

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., Competing Interests: Declarations of interest: none, (© 2021 The Authors.)

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., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Third-generation cephalosporin resistance (3GC-R) in Escherichia coli is a rising problem in human and farmed-animal populations. We conducted whole-genome sequencing analysis of 138 representative 3GC-R isolates previously collected from dairy farms in southwest England and confirmed by PCR to carry acquired 3GC-R genes. This analysis identified bla CTX-M (131 isolates encoding CTX-M-1, -14, -15, -and 32 and the novel variant CTX-M-214), bla CMY-2 (6 isolates), and bla DHA-1 (1 isolate). A highly conserved plasmid was identified in 73 isolates, representing 27 E. coli sequence types. This novel ∼220-kb IncHI2 plasmid carrying bla CTX-M-32 was sequenced to closure and designated pMOO-32. It was found experimentally to be stable in cattle and human transconjugant E. coli even in the absence of selective pressure and was found by multiplex PCR to be present on 26 study farms representing a remarkable range of transmission over 1,500 square kilometers. However, the plasmid was not found among human urinary E. coli isolates we recently characterized from people living in the same geographical location, collected in parallel with farm sampling. There were close relatives of two bla CTX-M plasmids circulating among eight human and two cattle isolates, and a closely related bla CMY-2 plasmid was found in one cattle and one human isolate. However, phylogenetic evidence of recent sharing of 3GC-R strains between farms and humans in the same region was not found. IMPORTANCE Third-generation cephalosporins (3GCs) are critically important antibacterials, and 3GC resistance (3GC-R) threatens human health, particularly in the context of opportunistic pathogens such as Escherichia coli There is some evidence for zoonotic transmission of 3GC-R E. coli through food, but little work has been done examining possible transmission via interaction of people with the local near-farm environment. We characterized acquired 3GC-R E. coli found on dairy farms in a geographically restricted region of the United Kingdom and compared these with E. coli from people living in the same region, collected in parallel. While there is strong evidence for recent farm-to-farm transmission of 3GC-R strains and plasmids-including one epidemic plasmid that has a remarkable capacity to be transmitted-there was no evidence that 3GC-R E. coli found on study farms had a significant impact on circulating 3GC-R E. coli strains or plasmids in the local human population., (Copyright © 2020 American Society for Microbiology.)

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., (Copyright © 2020 Buller, Adam, Bard, Bruce, (Ray) Chan, Hinchliffe, Morgans, Rees and Reyher.)

Background: Communication skills to promote changes in management routines are especially important in veterinary herd health management (VHHM). Motivational interviewing (MI) is a communication methodology shown to be effective in stimulating client behaviour change. This study aimed to evaluate a 6-month MI-training programme for veterinarians., Methods: Thirty-eight cattle veterinarians gathered in groups of four to eight at six workshops separated by 3-4 weeks, during which they read literature and practised their skills. MI skills were evaluated before and after training using audio recordings of role-play conversations with professional actors. Recordings were coded using the MI Treatment Integrity Code (MITI) V.4.2.1. The effect of training was evaluated by 16 regression models. Participants filled in questionnaires about their experiences., Results: All participants improved their MI skills after training in at least one parameter and significant improvements were found in all but 3 of the 16 statistically evaluated MITI variables. The mean (25th-75th percentiles) ratings of the veterinarians' perceived relevance of MI skills in their work was 4.9 (4.0-6.0) and of their satisfaction with the programme was 5.1 (5.0-6.0) on a 6-point Likert scale., Conclusions: Results show that MI training was perceived to be useful and relevant and successfully improved veterinarians' communication skills in VHHM., Competing Interests: Competing interests: LF is a partner at MIC Lab AB and HW is a partner at MeetMe Psykologkonsult AB. Research results demonstrating positive effects of MI in veterinary medicine may increase the market for codings for MIC Lab AB and the market for educational concepts in MI for MeetMe Psykologkonsult AB. CS, UE, KR and AMB have no conflict of interest to report., (© British Veterinary Association 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)

Objectives: To characterize putative AmpC-hyperproducing third-generation cephalosporin-resistant E. coli from dairy farms and their phylogenetic relationships; to identify risk factors for their presence; and to assess evidence for their zoonotic transmission into the local human population., Methods: Proteomics was used to explain differences in antimicrobial susceptibility. WGS allowed phylogenetic analysis. Multilevel, multivariable logistic regression modelling was used to identify risk factors., Results: Increased use of amoxicillin/clavulanate was associated with an increased risk of finding AmpC hyperproducers on farms. Expansion of cephalosporin resistance in AmpC hyperproducers was seen in farm isolates with marR mutations (conferring cefoperazone resistance) or when AmpC was mutated (conferring fourth-generation cephalosporin and cefoperazone resistance). Phylogenetic analysis confirmed the dominance of ST88 amongst farm AmpC hyperproducers but there was no evidence for acquisition of farm isolates by members of the local human population., Conclusions: Clear evidence was found for recent farm-to-farm transmission of AmpC-hyperproducing E. coli and of adaptive mutations to expand resistance. Whilst there was no evidence of isolates entering the local human population, efforts to reduce third-generation cephalosporin resistance on dairy farms must address the high prevalence of AmpC hyperproducers. The finding that amoxicillin/clavulanate use was associated with an increased risk of finding AmpC hyperproducers is important because this is not currently categorized as a highest-priority critically important antimicrobial and so is not currently targeted for specific usage restrictions in the UK., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Knowledge of accurate weights of cattle is crucial for effective dosing of individual animals and for reporting antimicrobial usage. For the first time, we provide an evidence-based estimate of the average weight of UK dairy cattle to better inform farmers, veterinarians and the scientific community., Methods: Data were collected for 2747 lactating dairy cattle from 20 farms in the UK. Data were used to calculate a mean weight for lactating dairy cattle by breed and a UK-specific mean weight. Trends in weight by lactation number and production level were also explored., Results: Mean weight for adult dairy cattle in this study was 617 kg (sd=85.6 kg). Mean weight varied across breeds, with a range of 466 kg (sd=56.0 kg, Jersey) to 636 kg (sd=84.1, Holsteins). When scaled to UK breed proportions, the estimated UK-specific mean weight was 620 kg., Conclusion: This study is the first to calculate a mean weight of adult dairy cattle in the UK based on on-farm data. Overall mean weight was higher than that most often proposed in the literature (600 kg). Evidence-informed weights are crucial as the UK works to better monitor and report metrics to measure antimicrobial use and are useful to farmers and veterinarians to inform dosing decisions., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Achieving herd health and welfare improvement increasingly relies on cattle veterinarians to train and advise farmers, placing veterinary interactions at the heart of knowledge exchange. Cattle veterinarians recognize their influence and the need to be proactive advisors but struggle with acting upon this awareness in daily practice, reporting a need to enhance their advisory approach to inspire farmer behavior change. Understanding how veterinarian-farmer interactions positively or negatively influence the enactment of change on farm is therefore essential to support the cattle veterinary profession. This paper adopts a qualitative approach to conceptualize how and under what circumstances veterinary advice has the potential to support and inspire farmer engagement with behavior change on the UK dairy farm. Fourteen UK dairy farms were recruited to take part in a qualitative study involving research observation of a typical advisory consultation between veterinarian and farmer (n = 14) followed by separate, in-depth interviews with the farmer(s) and their respective veterinarian. Interview data were organized using a template coding method and analyzed thematically. While accuracy of veterinary advisory content was valued, it was a relational context of trust, shared veterinarian-farmer understanding, and meaningful interpretation of advice at a local (farmer) level that was most likely to enact change. Critically, these relational factors were reported to work together synergistically; a trusting relationship was an essential, but not necessarily sufficient, component to create a culture of change. Findings suggest that cattle veterinarians may benefit from tailoring advisory services to the farmer's specific world view, facilitated by a shared understanding of the farmer's immediate and long-term motivational drivers. In consequence, cattle veterinarians seeking to positively engage farmers in advisory interactions could consider a focus on farmer priorities, motivations, and goals as paramount to frame and inform advisory messages. This explicit collaborative communication encourages the selection of appropriate and timely veterinary expertise, leading to better integration and adoption of advice on farm given enhanced advisory relevance for farmers' unique circumstances. This farmer-centered approach, involving active co-creation of plans between individuals, is critical for engagement and commitment when tackling complex problems., (Copyright © 2019 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Intrauterine growth retardation (IUGR) may result in reduced birthweight and detrimental physiological alterations in neonates. This prospective cohort study was designed to assess if there exists an association between birthweight of dairy calves and incidence of bovine respiratory disease (BRD), neonatal calf diarrhoea (NCD) or mortality during the pre-weaning period. Calves (n=476) on 3 farms in South West England were weighed at birth. Farmers kept records of treatments for NCD and BRD and calves were assessed weekly using clinical scoring systems (Wisconsin Calf Health Scores, California Calf Health Scores and Faeces Scores). Missing data were present in several variables. Multiple imputation coupled with generalised estimating equations (MI-GEE analysis) was employed to analyse associations between several calf factors, including birthweight, and probability of a case of BRD or NCD. Associations between calf factors and mortality were assessed using multiple logistic regression. Associations between birthweight and disease incidence were scarce. Birthweight was associated with odds of a positive Faeces Score on one farm only in the MI-GEE analysis (O.R. 1.03, 95% C.I. 1.0005-1.05, P=0.046). Birthweight was not associated with probability of mortality. This research suggests that birthweight, and therefore IUGR, is not associated with health of pre-weaned dairy calves., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

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., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2018. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)

Due to scientific, public and political concern regarding antimicrobial resistance (AMR), several EU countries have already taken steps to reduce antimicrobial (AM) usage in production animal medicine, particularly that of the highest priority critically important AMs (HP-CIAs). While veterinarians are aware of issues surrounding AMR, potential barriers to change such as concerns of reduced animal health, welfare or production may inhibit progress towards more responsible AM prescribing. Farmers from seven dairy farms in South West England engaged in changing AM use through an active process of education and herd health planning meetings. Prescribing data were collected from veterinary sales records; production and health data were accessed via milk recording and farm-recorded data. This study demonstrates that cattle health and welfare-as measured by production parameters, fertility, udder health and mobility data and culling rates-can be maintained and even improved alongside a complete cessation in the use of HP-CIAs as well as an overall reduction of AM use on dairy farms. This study also identified a need to consider different metrics when analysing AM use data, including dose-based metrics as well as those of total quantities to allow better representation of the direction and magnitude of changes in AM use., Competing Interests: Competing interests: None declared., (© British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The issue of antimicrobial resistance is of global concern across human and animal health. In 2016, the UK government committed to new targets for reducing antimicrobial use (AMU) in livestock. Although a number of metrics for quantifying AMU are defined in the literature, all give slightly different interpretations. This paper evaluates a selection of metrics for AMU in the dairy industry: total mg, total mg/kg, daily dose and daily course metrics. Although the focus is on their application to the dairy industry, the metrics and issues discussed are relevant across livestock sectors. In order to be used widely, a metric should be understandable and relevant to the veterinarians and farmers who are prescribing and using antimicrobials. This means that clear methods, assumptions (and possible biases), standardised values and exceptions should be published for all metrics. Particularly relevant are assumptions around the number and weight of cattle at risk of treatment and definitions of dose rates and course lengths; incorrect assumptions can mean metrics over-represent or under-represent AMU. The authors recommend that the UK dairy industry work towards the UK-specific metrics using the UK-specific medicine dose and course regimens as well as cattle weights in order to monitor trends nationally., Competing Interests: Competing interests: None declared., (© British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

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., Competing Interests: Competing interests: None declared., (© British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The split upper eyelid defect (SUED) is a congenital defect of the upper eyelid thought to be exclusive to multihorned sheep. Eleven flocks with a high proportion of multihorned Hebridean sheep were visited in 2011. Statistical analysis was performed generating Pearson's chi-squared analysis, as well as (1) logistic regression, (2) ordinal logistic regression and (3) linear regression models. Four hundred and seventy-three pure-bred Hebridean sheep and one crossbred lamb were examined. Of all the multihorned animals inspected in 2011, 9.7 per cent of adults had evidence of SUED in one or more eyelids, with 17.6 per cent of lambs presented with one or more eyelid affected. Having five or more horns was protective in the linear regression model on eye-level data (p=0.045). Forward-facing horns were consistently associated with a 'worst' eye score in the eye-level data, with an odds ratio (OR) as high as 9.4 when compared with a base of backward-facing horns (p=0.002). Eyes positive for SUED were significantly more likely to be rose bengal stain-positive in all four analysis, including multilevel mixed effect ordered logistic regression (p<0.001, OR 149.3). A novel lesion was identified during the course of the study, with 3.4 per cent of lambs presented with dermoid. SUED was also identified in a crossbred animal. Further work is needed to quantify the exact cost to animals with unilateral or bilateral SUED with subtle and production cost of SUED., Competing Interests: Competing interests: None declared., (© British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Client behaviour change is at the heart of veterinary practice, where promoting animal health and welfare is often synonymous with engaging clients in animal management practices. In the medical realm, extensive research points to the link between practitioner communication and patient behavioural outcomes, suggesting that the veterinary industry could benefit from a deeper understanding of veterinarian communication and its effects on client motivation. Whilst extensive studies have quantified language components typical of the veterinary consultation, the literature is lacking in-depth qualitative analysis in this context. The objective of this study was to address this deficit, and offer new critical insight into veterinary communication strategies in the pursuit of client behaviour change. Role-play interactions (n = 15) between UK cattle veterinarians and an actress experienced in medical and veterinary education were recorded, transcribed and analysed thematically. Analysis revealed that, overall, veterinarians tend to communicate in a directive style (minimal eliciting of client opinion, dominating the consultation agenda, prioritising instrumental support), reflecting a paternalistic role in the consultation interaction. Given this finding, recommendations for progress in the veterinary industry are made; namely, the integration of evidence-based medical communication methodologies into clinical training. Use of these types of methodologies may facilitate the adoption of more mutualistic, relationship-centred communication in veterinary practice, supporting core psychological elements of client motivation and resultant behaviour change.

Critically Appraised Topics (CATs) are a standardised, succinct summary of research evidence organised around a clinical question, and a form of evidence synthesis used in the practice of evidence-based medicine (EBM) and evidence-based veterinary medicine (EBVM). Access to CATs enables clinicians to incorporate evidence from the scientific literature into clinical practice and they have been used to teach EBVM at the University of Bristol's School of Veterinary Sciences since 2011. CATs from Bristol university will be regularly published in the Clinical Decision Making section of Veterinary Record. The first CAT was published in VR, January 30, 2016, vol 178, pp 118-119., (British Veterinary Association.)

Critically Appraised Topics (CATs) are a standardised, succinct summary of research evidence organised around a clinical question, and a form of evidence synthesis used in the practice of evidence-based medicine (EBM) and evidence-based veterinary medicine (EBVM). Access to CATs enables clinicians to incorporate evidence from the scientific literature into clinical practice and they have been used to teach EBVM at the University of Bristol's School of Veterinary Sciences since 2011. Veterinary Record is including CATs from Bristol university in its Clinical Decision Making section. The first of these, along with an explanation of how they can be used, was published in VR, January 30, 2016, vol 178, pp 118-119., (British Veterinary Association.)

Sub-optimal heifer growth is associated with higher disease rates and reduced future performance and longevity in the dairy herd. This report describes a system for measuring heifer growth from birth to first calving that was used on commercial dairy farms in South West England, in order to gather benchmarking data to feed back to farmers. Weights (n = 8443) were collected from 20 farms. There was a marked variation in individual and herd mean growth rates. Overall, calves gained no weight in the first 8 days after birth and had a very low growth rate (median 0.12 kg/day) up to 30 days, a period when feed conversion efficiency is high and calves are vulnerable to disease. Heifers whose growth rate up to 180 days was low were significantly less likely to achieve target service weight (374 kg) by 420 days. Monitoring heifer growth during the rearing period enables farmers to improve heifer growth rates and so impact both the efficiency of heifer rearing and, potentially, the productivity and performance of the adult herd., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Estimates of the weights of dairy cattle by veterinary surgeons (n = 53), stock handlers (n = 42) and students (n = 77) were compared with heart girth measurements, which were used as a predictor of bodyweight. Visual live weight estimation was variable in accuracy. Fifty-five per cent of weight estimates were >10% from the reference weight, and the mean absolute percentage difference for all estimates was 15% (standard deviation 15%, interquartile range 5-20%). Underestimation was more frequent at higher weights, and accuracy of estimation was lower as weight increased. Overestimation tended to occur more frequently at weights <150 kg., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Mastitis is a complex disease affecting dairy cows and is considered to be the most costly disease of dairy herds. The hazard of mastitis is a function of many factors, both managerial and environmental, making its control a difficult issue to milk producers. Observational studies of clinical mastitis (CM) often generate datasets with a number of characteristics which influence the analysis of those data: the outcome of interest may be the time to occurrence of a case of mastitis, predictors may change over time (time-dependent predictors), the effects of factors may change over time (time-dependent effects), there are usually multiple hierarchical levels, and datasets may be very large. Analysis of such data often requires expansion of the data into the counting-process format - leading to larger datasets - thus complicating the analysis and requiring excessive computing time. In this study, a nested frailty Cox model with time-dependent predictors and effects was applied to Canadian Bovine Mastitis Research Network data in which 10,831 lactations of 8035 cows from 69 herds were followed through lactation until the first occurrence of CM. The model was fit to the data as a Poisson model with nested normally distributed random effects at the cow and herd levels. Risk factors associated with the hazard of CM during the lactation were identified, such as parity, calving season, herd somatic cell score, pasture access, fore-stripping, and proportion of treated cases of CM in a herd. The analysis showed that most of the predictors had a strong effect early in lactation and also demonstrated substantial variation in the baseline hazard among cows and between herds. A small simulation study for a setting similar to the real data was conducted to evaluate the Poisson maximum likelihood estimation approach with both Gaussian quadrature method and Laplace approximation. Further, the performance of the two methods was compared with the performance of a widely used estimation approach for frailty Cox models based on the penalized partial likelihood. The simulation study showed good performance for the Poisson maximum likelihood approach with Gaussian quadrature and biased variance component estimates for both the Poisson maximum likelihood with Laplace approximation and penalized partial likelihood approaches., (Copyright © 2014. Published by Elsevier B.V.)

Evidence-based veterinary medicine (EBVM) is of interest and relevance to veterinary practitioners. Consequently, veterinary schools take responsibility for teaching students how to appraise scientific articles and for equipping them with the skills needed to obtain and evaluate the best evidence and to apply this approach to their own cases. As part of our farm animal clinical rotation, we train students in qualitative and quantitative EBVM methods using an e-learning environment, online teaching materials, a wiki (a Web site that allows its users to edit its content via a Web browser), and face-to-face tutorials that support learning. Students working in small groups use a wiki to record details of the history, clinical presentation, diagnostic tests, herd data, and management plans for their chosen farm animal clinical cases. Using a standardized patient, intervention, comparison, and outcome (PICO) format, each group formulates a patient question based on either a proposed intervention or diagnostic procedure for the case and conducts an online scientific literature database search. The students appraise the articles retrieved using EBVM approaches and record the information in the wiki. The summation of this body of work, the group's critically appraised topic (CAT), includes the original PICO, a standardized table of the scientific evidence for the effectiveness of the intervention or diagnostic procedure, a summary statement in the form of a clinical bottom line, and their reflections upon the CAT. At the end of the rotation, students take part in a structured "CAT Club" where they present and discuss their findings with fellow students and clinicians.

Questionnaires are frequently used instruments to collect data in epidemiological studies. In countries where more than one language is spoken, the development of a questionnaire in more than one language is needed. The objective of this study was to develop and test the repeatability and validity of English and French versions of a personal interview-format questionnaire designed to capture udder health related management practices used on dairy farms. A standardized protocol was used to develop and translate the research instrument. Equivalence of the English and French questionnaires was assessed using a cross-over study design with 24 bilingual dairy producers completing both versions on three different occasions in a randomly assigned sequence. Repeatability of the questionnaire was evaluated using the test-retest method with the same questions being asked on two different occasions to 88 dairy producers participating in the National Cohort of Dairy Farms of the Canadian Bovine Mastitis Research Network. Validity of the questions related to milking procedures and general housing was assessed using on-farm observations as a gold standard. Measures of agreement were calculated using kappa, quadratic-weighted Kappa and concordance correlation coefficients for categorical, ordinal and continuous variables, respectively. Sensitivity and specificity estimates were computed for the validity analysis. The overall equivalence of the English and French versions of the questionnaire was adequate; agreement measures when administered twice in the same language were not significantly higher than when administered in each language. Similarly, questionnaire overall repeatability was good. When accounting for prevalence bias, Kappa and CCC estimates ranged from 0.40 to 0.92 for 27 of the 29 items evaluated in the questionnaire, with 18 items yielding agreement estimates greater than 0.60. Finally, milking procedures and general housing questions validity was excellent with mean sensitivity and specificity of 86% and 92%, respectively. Although the overall evaluation of the instrument was satisfactory, specific doubtful items were identified. This illustrates the need to address questionnaire reliability as even rigorously designed and pre-tested questions can have poor repeatability or validity. Our results indicate that the developed English and French questionnaires can be used simultaneously to accurately measure the udder health related management practices used on Canadian dairy farms. This questionnaire is adaptable for use in other developed dairy industry populations. The questionnaire is freely available online at www.mastitisnetwork.org under the "Publications/others" section., ((c) 2010 Elsevier B.V. All rights reserved.)

Discussion between faculty and interested students revealed the existence of a multitude of opportunities in dairy production medicine at the College of Veterinary Medicine at Cornell University. Many of these were not well known to students, or even to some of the faculty, and the means of accessing specific learning experiences were sometimes obscure. Together, an informal group of faculty, students, and alumni set about cataloging available educational opportunities, resulting in a 31-page publication referred to as the "Opportunities Map." Essentially a student handbook for production medicine students, the Opportunities Map at Cornell helps guide the travel of food animal-interested students through the curriculum without missing the important highlights along the way. The map was originally developed to chronicle the opportunities and resources available to students, but it has also been used to foster face-to-face communications between students and faculty, to welcome incoming students with production animal interests, and to provide a baseline description for further discussion about the curriculum.