Inappropriate use of antibiotics in humans and animals contributes to decreased antimicrobial susceptibility in bacteria of medical importance. Resistant bacteria being transferred from animals to humans are causing public health concern. In-person interviews were conducted with 20 dairy farmers in rural counties of South Carolina to determine farmers' knowledge and attitudes about prudent antibiotic use among livestock. Four focus groups (n = 22) were also conducted to ascertain farmers' specific information needs about proper antibiotic use. Survey results showed that participants (100%) typically determined a need for antibiotic treatment using symptom assessment and reported following some form of operating procedures regarding administration of antibiotics. Few farmers (32%) had actual written antibiotic protocols. Preferred information sources about antibiotics were veterinarians (100%) and other dairy farmers (50%). Most farmers (86%) were not concerned that overuse of antibiotics in animals could result in antibiotic resistance among farm workers. Qualitative analysis of focus groups revealed significant barriers to following proper antibiotic procedures including limited finances and lack of time. The need for bilingual educational resources for Hispanic/Latino dairy workers was expressed. Desired formats for educational materials were posters, flowcharts, videos, and seminars. Education of South Carolina dairy farmers by veterinarians and public health professionals on the appropriate use of antibiotics in dairy cattle is needed to ensure antibiotic effectiveness in both animals and humans.

Food safety and food defense are both responsibilities of public health agencies. Food safety practices within restaurants are regulated by state and local public health laws based on the US Food and Drug Administration Model Food Code. However, little is known about preemptive practices against intentional food-borne outbreaks within restaurants. The researchers administered a survey to a 50 percent random sample of South Carolina's restaurants, a state that relies heavily on tourism and the restaurant industry for its economic well-being. The survey received a response rate of 15 percent. The food defense practice items fall under three functional categories: employee management and training practices; vendor and delivery-related practices; and physical facilities and operational security practices. This study presents the results, classified by geographic region. Findings indicate some key areas of vulnerability that need attention to protect the public from mass food outbreaks due to intentional contamination. Of concern, there is much variation in practices by geographic region. On the basis of the survey, recommendations are made to improve restaurant preparedness against food-borne outbreaks from terrorism and malevolent contamination.

In the age of preparedness, public health agencies are concerned with intentional acts of food contamination in restaurants, in addition to food safety. Food safety consists of applying standard norms of practice and infrastructure, which, if violated, cause food-borne illness. In contrast, food defense requires an institutionalized mindset of informed alertness to unusual variations from the norms, combined with preemptive practices best suited to each restaurant. Therefore, while food safety lends itself to regulation to ensure standard practices, food defense is best served by advisory guidelines for autonomous application, preserving the restaurant industry's core values of hospitality and customer service. To address this challenge, public health agencies need survey tools that can yield action-relevant data on the knowledge and practice gaps in food defense preparedness and on educational messages and support services to be developed for maximum impact potential. This article presents a mail survey instrument, developed using qualitative research to ensure content and face validity. Instrument development involved drafting the survey on the basis of expert consultations, validating its content by using focus groups (representing all restaurant categories and geographic regions), and ensuring face validity through cognitive interviews. The resulting survey remains sensitive to the hospitality industry while encompassing all vulnerable points.