Identifying temporal variation in reported births, deaths and movements of cattle in Britain

BACKGROUND: The accuracy of predicting disease occurrence using epidemic models relies on an understanding of the system or population under investigation. At the time of the Foot and Mouth disease (FMD) outbreak of 2001, there were limited reports in the literature as to the cattle population structure in Britain. In this paper we examine the temporal patterns of cattle births, deaths, imports and movements occurring within Britain, reported to the Department for the Environment, Food and Rural Affairs (DEFRA) through the British Cattle Movement service (BCMS) during the period 1(st )January 2002 to 28(th )February 2005. RESULTS: In Britain, the number of reported cattle births exhibit strong seasonality characterised by a large spring peak followed by a smaller autumn peak. Other event types also exhibit strong seasonal trends; both the reported number of cattle slaughtered and "on-farm" cattle deaths increase during the final part of the year. After allowing for seasonal components by smoothing the data, we illustrate that there is very little remaining non-seasonal trend in the number of cattle births, "on-farm" deaths, slaughterhouse deaths, on- and off-movements. However after allowing for seasonal fluctuations the number of cattle imports has been decreasing since 2002. Reporting of movements, births and deaths was more frequent on certain days of the week. For instance, greater numbers of cattle were slaughtered on Tuesdays, Wednesdays and Thursdays. Evidence for digit preference was found in the reporting of births and "on-farm" deaths with particular bias towards over reporting on the 1(st), 10(th )and 20(th )of each month. CONCLUSION: This study provides insight into the population and movement dynamics of the British cattle population. Although the population is in constant flux, seasonal and long term trends can be identified in the number of reported births, deaths and movements of cattle. Incorporating this temporal variation in epidemic disease modelling may result in more accurate model predictions and may usefully inform future surveillance strategies

Could it be colic? Horse-owner decision making and practices in response to equine colic

Background: Little is known about lay understanding and decision making in response to colic. Horse-owners/ carers are key to identifying colic and initiating veterinary intervention. Understanding how owners think and act in relation to colic could assist veterinary surgeons in tailoring information about colic with the aim of improving colic outcomes. Methods: A mixed methods approach was employed including qualitative in-depth interviews and a cross- sectional questionnaire. Qualitative data were analysed using Grounded theory to conceptualise processes involved in horse-owner management of colic. Following this, a cross-sectional survey was designed to test these concepts. Cluster analysis explored the role of the human-horse relationship upon colic management strategies. Results: Fifteen horse-owners with a range of colic experience participated in the interviews. A theoretical conceptual model was developed and described how horse-owners’ recognised, assessed and responded to colic. Three main management strategies were used including ‘wait and see’, ‘lay treatments’ and ‘seek veterinary assistance’. Actions in response to colic were moderated by owners’ experience of colic and interpretation of the severity of colic signs. A postal questionnaire gathered data from 673 horse-owners from the North-West of the UK. The majority (605, 89.9%) of respondents were female. Cluster analysis revealed 5 meaningful groups of horse- owners based upon assessment of questionnaire items on the human-horse relationship. These groups included 2 professional and 3 amateur owner typologies. There were differences in the responses to some questionnaire items among the identified groups. Conclusions: This study describes lay understanding and management of colic among a population of horse- owners from the North-West of the UK. The information may serve as a basis upon which to tailor existing programmes designed to educate owners about colic management strategies, and may inform veterinarians’ interactions with horse-owners.

GP coding behaviour for non-specific clinical presentations: a pilot study

Background: Clinical coding is an integral part of primary care. Disease incidence studies based on primary care electronic health records (EHRs) rely on the accuracy of these codes. Current code validation methods are not appropriate for non-specific conditions and provide limited information about GPs' decision-making behaviour around coding. Qualitative methods could offer insight into decision-making behaviour around coding of patients with non-specific conditions. Aim: To investigate the decision-making behaviour of GPs when applying Read codes to non-specific clinical presentations, using Lyme disease as a case example. Design & setting: A pilot study was undertaken, involving masked semi-structured interviews of eight GPs in the North West of England. Method: Semi-structured interviews were carried out based on 11 clinical cases representative of Lyme disease presentations. Discrete answers were described descriptively. Interview transcripts were analysed using a thematic approach. Results: Themes underpinning GPs’ coding behaviour included: GP personal and professional experience; clinical evidence; diagnostic uncertainty; professional integrity and defensive practice; and patient-sourced health information and beliefs. GPs placed Lyme disease on their differential diagnosis list for five cases; in only two cases would GPs select a Lyme disease related Read code. Conclusion: GPs were reluctant to code with specific diagnostic Read codes when they were presented with patients with vague or unfamiliar symptomology. This masked questionnaire methodology offers a new approach to validate incidence figures, based on Read codes of non-specific conditions. The reluctance to code poses many problems for primary care EH

“Catch 22”: biosecurity awareness, interpretation and practice amongst poultry catchers

Campylobacter contamination of chicken on sale in the UK remains at high levels and has a substantial public health impact. This has prompted the application of many interventions in the supply chain, including enhanced biosecurity measures on-farm. Catching and thinning are acknowledged as threats to the maintenance of good biosecurity, yet the people employed to undertake this critical work (i.e. ‘catchers’) are a rarely studied group. This study uses a mixed methods approach to investigate catchers’ (n = 53) understanding of the biosecurity threats posed by the catching and thinning, and the barriers to good biosecurity practice. It interrogated the role of training in both the awareness and practice of good biosecurity. Awareness of lapses in biosecurity was assessed using a Watch-&-Click hazard awareness survey (n = 53). Qualitative interviews (n = 49 catchers, 5 farm managers) explored the understanding, experience and practice of catching and biosecurity. All of the catchers who took part in the Watch-&-Click study identified at least one of the biosecurity threats with 40% detecting all of the hazards. Those who had undergone training were significantly more likely to identify specific biosecurity threats and have a higher awareness score overall (48% compared to 9%, p = 0.03). Crucially, the individual and group interviews revealed the tensions between the high levels of biosecurity awareness evident from the survey and the reality of the routine practice of catching and thinning. Time pressures and a lack of equipment rather than a lack of knowledge appear a more fundamental cause of catcher-related biosecurity lapses. Our results reveal that catchers find themselves in a ‘catch-22′ situation in which mutually conflicting circumstances prevent simultaneous completion of their job and compliance with biosecurity standards

Can policy be risk-based? The cultural theory of risk and the case of livestock disease containment

This article explores the nature of calls for risk-based policy present in expert discourse from a cultural theory perspective. Semi-structured interviews with professionals engaged in the research and management of livestock disease control provide the data for a reading proposing that the real basis of policy relating to socio-technical hazards is deeply political and cannot be purified through ‘escape routes’ to objectivity. Scientists and risk managers are shown calling, on the one hand, for risk-based policy approaches while on the other acknowledging a range of policy drivers outside the scope of conventional quantitative risk analysis including group interests, eventualities such as outbreaks, historical antecedents, emergent scientific advances and other contingencies. Calls for risk-based policy are presented, following cultural theory, as ideals connected to a reductionist epistemology and serving particular professional interests over others rather than as realistic proposals for a paradigm shift

Participatory appraisal of the impact of epizootic lymphangitis in Ethiopia

Epizootic lymphangitis (EZL) is reported to have a significant impact upon livelihoods within resource-poor settings. This study used a participatory approach to explore peoples’ experiences of EZL and examine the perceived impact of disease, owner knowledge and understanding of EZL, lay management of disease and, attitudes and strategies towards disease prevention. Focus-group discussions were held with 358 cart-horse owners and drivers recruited from 7 towns attended by SPANA (Society for the protection of animals abroad) mobile veterinary clinics and 2 unexposed towns where no SPANA clinics were available. Focus group discussions explored four main research questions: (1) Is EZL recognised by animal owners, and is this considered an important disease in equids? (2) What factors do animal owners associate with the development of disease? (3) What happens to an animal with clinical disease and how does this impact upon the owner/community? (4) Are measures taken to reduce disease occurrence? These key areas were explored using photographs, disease ranking, matrices and open discussion. Data were analysed using descriptive statistics and thematic analysis. The results are presented thematically and include: recognition and descriptions of EZL, treatment strategies used, disease priorities and ranking, impact of disease, disease transmission and attitudes and approaches to disease prevention. EZL was widely recognised and ranked highly as an important disease of equids. However, there was uncertainty around identifying early cases of EZL, and this could impact upon the timing of initiating treatment and separating potentially infectious animals. People had varying knowledge of effective methods for disease prevention and reported particular difficulties with isolating infected animals. The impact of EZL was multi-dimensional and encompassed effects upon the horse, the individual owner and the wider society. Working equids provide a vital utility and source of income to many people in resource-poor settings. Often, infection with EZL resulted in a reduction in working ability which had a direct impact upon the livelihoods of owners and their dependent family members. EZL also impacted upon the welfare of the horse as sick animals continued to be worked and, in advanced cases, horses were abandoned due to ineffective or unavailable treatment. This study conceptualises the importance of EZL due to the effects of the disease on the horse and its impact upon human livelihoods. Epizootic lymphangitis is a neglected disease that requires further investigation in order to develop practical and sustainable disease control strategies within endemic regions

A survey of UK healthcare workers' attitudes on volunteering to help with the Ebola outbreak in West Africa

Objective To understand the barriers and enablers for UK healthcare workers who are considering going to work in the current Ebola outbreak in West Africa, but have not yet volunteered. Design After focus group discussions, and a pilot questionnaire, an anonymous survey was conducted using SurveyMonkey to determine whether people had considered going to West Africa, what factors might make them more or less likely to volunteer, and whether any of these were modifiable factors. Participants The survey was publicised among doctors, nurses, laboratory staff and allied health professionals. 3109 people answered the survey, of whom 472 (15%) were considering going to work in the epidemic but had not yet volunteered. 1791 (57.6%) had not considered going, 704 (22.6%) had considered going but decided not to, 53 (1.7%) had volunteered to go and 14 (0.45%) had already been and worked in the epidemic. Results For those considering going to West Africa, the most important factor preventing them from volunteering was a lack of information to help them decide; fear of getting Ebola and partners’ concerns came next. Uncertainty about their potential role, current work commitments and inability to get agreement from their employer were also important barriers, whereas clarity over training would be an important enabler. In contrast, for those who were not considering going, or who had decided against going, family considerations and partner concerns were the most important factors. Conclusions More UK healthcare workers would volunteer to help tackle Ebola in West Africa if there was better information available, including clarity about roles, cover arrangements, and training. This could be achieved with a well-publicised high quality portal of reliable information