Nordic veterinarians' threshold for medical treatment of dairy cows, influence on disease recording and medicine use: mild clinical mastitis as an example.

National databases for dairy cows in the four Nordic countries, Denmark, Finland, Norway and Sweden, have been found to capture varying proportions of disease events on farm. A variation in the thresholds of veterinarians to initiate medical treatment may be a reason for this. Studying these thresholds may increase the understanding of prudent use of antibiotics. The primary objective of this study was to investigate whether Nordic veterinarians, on a between country-level, vary in their intention to start medical treatment of a dairy cow with mild clinical mastitis, on the same day as making the diagnosis. The threshold for initiating treatment was quantified as an intention score. Secondary, underlying behavioural components of the intention score was studied within each country. A social psychology model, the Theory of Planned Behaviour (TPB), was used to design a questionnaire that was distributed to 1047 veterinarians in cattle practice in the four countries during autumn 2010. The response rate was around 50% in all the countries, and 543 observations were retained for analysis. The between-country differences in intention were tested with one-way analysis of variance. Multivariable linear regression was used to estimate the proportion of variability in intention explained by the three behavioural components, attitude, subjective norm and perceived behavioural control. The Spearman rank correlations between specific beliefs about the behaviour and intention scores were estimated to find beliefs of high influence on the decision to treat or not. Intention scores differed between all countries (p<0.05) except between NO and SE (p=0.06). The mean intention scores were 0.71, 0.42, 0.58 and 0.50 in DK, FI, NO and SE, respectively. As measured by the adjusted R(2) in linear regression models, the underlying behavioural components of the TPB explained 0.37, 0.41, 0.40 and 0.48 of the variation in intention scores in DK, FI, NO and SE, respectively. Attitude was the most important predictor in DK, NO and SE, but perceived behavioural control was most important in FI. In all countries the specific attitude belief of highest influence was that starting treatment the same day as diagnosing a case of mild clinical mastitis gives the best result, compared to delaying treatment. The varying intentions of veterinarians to initiate medical treatment are likely to influence centrally registered mastitis incidence. This study has given an improved understanding of this behaviour, which may be useful in intervention studies or campaigns aiming at prudent use of antibiotics on dairy farms.

Increases in the completeness of disease records in dairy databases following changes in the criteria determining whether a record counts as correct.

BACKGROUND: The four Nordic countries: Denmark (DK), Finland (FIN), Norway (NO) and Sweden (SE), all have national databases in which mainly records of treated animals are maintained. Recently, the completeness of locomotor disorder records in these databases has been evaluated using farmers' recordings as a reference level. The objective of the present study was to see how previous estimates of completeness figures are affected by the criteria determining whether a recording in the database is to be judged correct. These demands included date of diagnosis and disease classification. In contrast with the previous study, a period of time between the date of disease recording in the database and by the farmer was allowed. Further, the calculations were brought to bear on individual locomotor diagnoses instead of a common locomotor disease complex code. METHODS: Randomly selected dairy herds (≥15 cows) were invited to participate. During two 2-month periods in 2008 the farmers recorded the diseases they observed on the farm and their recordings constituted a farmer database (FD). These recordings were compared to disease recordings in the National Databases (ND). Earlier calculations of completeness for locomotor complex cases assuming an exact match on date were compared with ±7 day and ±30 day discrepancies calculated in this study. RESULTS: The farmers in DK, FIN, NO and SE recorded 426, 147, 97 and 193 locomotor disorders, respectively. When a window of ±7 days was allowed there was a relative increase in completeness figures lying in the range of 24-100%. Further increases were minor, or non-existent, when the window was expanded to ±30 days. The same trend was seen for individual diagnoses. CONCLUSION: In all four of the Nordic countries a common pattern can be observed: a further increase in completeness occurs when individual locomotor diagnoses recorded by the farmer are permitted to match any locomotor diagnosis recorded in the ND. Completeness increased when both time span and different diagnoses within the locomotor complex were allowed.

The association between farmers' participation in herd health programmes and their behaviour concerning treatment of mild clinical mastitis.

BACKGROUND: In Denmark, it has recently become mandatory for all dairy farmers with more than 100 cows to sign up for a herd health programme. Three herd health programmes are available. These differ in a number of aspects, including the frequency of veterinary visits and the farmer's access to prescription drugs. The objective of this study was to investigate whether dairy farmers' behavioural intentions, i.e. to call a veterinarian or start medical treatment on the day that they detect a cow with mild clinical mastitis (MCM), are different depending on the type of herd health programme. METHODS: A questionnaire survey based on the Theory of Planned Behaviour (TPB) was conducted. TPB proposes that a person's behavioural intention is strongly correlated with his or her actual behaviour. Three behavioural factors determine the behavioural intention: attitude, subjective norm and perceived behavioural control. Each of these factors is decided by a set of beliefs, each of which in turn is weighted by an evaluation: 1) the expected outcomes of performing the behaviour, 2) what a person believes that others think of the behaviour, and 3) the person's perceived power to influence the behaviour.A set of statements about the treatment of MCM based on interviews with 38 dairy farmers were identified initially. The statements were rephrased as questions and the resulting questionnaire was distributed to 400 randomly selected Danish dairy farmers who use the two most restrictive herd health programmes, either Core or Module1, and to all 669 farmers with the least restrictive herd health programme, Module2. The association between intention and the herd health programme was modelled using logistic regression. RESULTS: The farmers with the Module2 herd health programme had a significantly higher behavioural intention to perform the behaviour, when compared to farmers with a more restrictive herd health programme (OR = 2.1, p < 0.0001). CONCLUSION: Danish dairy farmers who participate in Module2 herd health programme had a higher intention to treat cases of MCM, compared to farmers who participate in a more restrictive herd health programme in which the veterinarian initiates treatments.