Antimicrobial resistance (AMR) is a global health emergency affecting humans and animals, diminishing the effectiveness of medication used to treat illness. The agri-food sector has attracted increased attention for imprudent antimicrobial use (AMU) and its contribution to AMR. Thus, ascertaining farmers’ and veterinarians’ behaviours surrounding AMU is essential to address imprudent AMU and generate behaviour change within the agri-food sector. Therefore, the aim of this critical review is to investigate, assess and collate the current body of evidence to identify psychosocial factors including knowledge, understanding, perceptions, attitudes and behaviours surrounding AMU. Database searches were limited to articles utilizing qualitative and quantitative methodologies, available in English with no restriction on publication year. Of the 1156 articles identified, 103 were retained for this review. Findings on the psychosocial aspects were thematically analysed. Five key themes emerged from the data: (i) knowledge and awareness of antimicrobials; (ii) attitudes towards antimicrobials; (iii) influential relationships; (iv) resources; and (v) factors influencing AMU. Results indicated that to overcome barriers experienced by key stakeholders, a carefully considered, evidence-based approach, incorporating behaviour change theory, is required when designing intricate interventions/strategies, in order to elicit successful and sustained AMU behaviour change.

To tackle antimicrobial resistance, it is vital that dairy farmers and veterinarians antimicrobial use behaviors and attitudes towards resistance are understood to identify how beliefs and motives influence practices. Current literature details qualitative and quantitative research exploring dairy farmer and veterinarian's knowledge, attitudes and perceptions on antimicrobial resistance and antimicrobial practices with varied and conflicting reported findings. Our objective was therefore to conduct a systematic review to assess the evidence and knowledge gaps in published literature. Articles were identified via database searches of Embase, Medline, PubMed, Scopus and Web of Science and were limited to published articles available in English with no publication year restrictions. Article screening was conducted at 3 levels: title, abstract and full text. Of the 349 articles identified, 35 were retained for systematic review. Transparency of reporting was assessed for each study using the Consolidated Criteria for Reporting Qualitative Research (COREQ) framework. Quality was assessed using the Critical Appraisal Skills Programme (CASP) qualitative checklist. Findings relating to dairy farmers and veterinarian's knowledge, attitudes and perceptions on antimicrobial resistance and practices were thematically analysed. Comprehensiveness of reporting was variable: studies reported between 5 and 26 of the 32 COREQ checklist items. Five key themes emerged from the data: (1) Knowledge and awareness of antimicrobial resistance, (2) Factors influencing farmer and veterinarian decision making, (3) Perceived barriers and facilitators to reduced antimicrobial use, (4) Perceived responsibility to antimicrobial resistance and (5) The role of the farmer and veterinarian relationship in reducing antimicrobial use. Awareness of prudent antimicrobial use was not uniform between reviewed studies. Many factors influence farmer and veterinarian's decisions to use antimicrobials including animal welfare and available resources. The farmer-veterinarian relationship is considered a potential barrier or facilitator of reduced antimicrobial use, depending on the DAIRY ANTIMICROBIAL USE: A SYSTEMATIC REVIEW 3 perceived relationship dynamic. Encouraging collaboration between farmers and veterinarians could lead to a shared responsibility to reducing antimicrobial use. This review provided a coherent picture of what is currently known and identified gaps in the current knowledge to be used to inform future behavioural intervention research. Increased knowledge, skill development, increased resources, increased engagement, and further research to address the gaps identified are the main recommendations to effectively overcome barriers and elicit appropriate behavior change to achieve reduced antimicrobial use in dairy cattle.

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There has been increased public interest and concerns in issues such as farm animal welfare (FAW) on the island of Ireland, stoked in part by political and governance changes, such as Brexit and COVID-19. Front-of-pack food labelling represents a primary information channel for many people. In advance of considering formalised food labelling schemes, specifically relating to FAW, it is important to ensure an up-to-date understanding of current consumer perceptions of FAW. With this aim, the current study utilised a mixed methodology. Nine focus group discussions (n = 41) and an online survey (n = 972) with food consumers in Ireland and Northern Ireland explored perceptions of FAW. Results suggest that overall perceptions of FAW are high, and consumers perceive FAW to have improved in the last decade. Quantitative (ANOVA) and qualitative results show variations in perception of FAW between sectors. Results from the focus group discussions identified factors underlying consumers’ perception of FAW: the living conditions of the animal, size and intensity of the farm, national standards and schemes, and visibility. Information insufficiencies and knowledge gaps were identified. The findings are discussed in relation to policy implications for the role of public engagement, front-of-pack welfare labelling, and quality assurance schemes.

The trace element iodine is a vital constituent of thyroid hormones. Iodine requirements increase during pregnancy, when even mild deficiency may affect the neurocognitive development of the offspring. Urinary iodine concentration (UIC) is the means of assessing iodine status in population surveys; a median UIC of 100-199 µg/L is deemed sufficient in a non-pregnant population. Milk is the main dietary source of iodine in the UK and Ireland. Methods We surveyed the iodine status of 903 girls aged 14-15 years in seven sites across the island of Ireland. Urine iodine concentration was measured in spot-urine samples collected between March 2014 and October 2015. Food group intake was estimated from iodine-specific food-frequency questionnaire. Milk iodine concentration was measured at each site in summer and winter. Results The median UIC overall was 111 µg/L. Galway was the only site in the deficient range (median UIC 98 µg/L). All five of the Republic of Ireland sites had UIC ≤105µg/L. In the two sites surveyed twice, UIC was lower in summer vs winter months (117 µg/L (IQR 76-165) vs 130 µg/L (IQR 91-194) (p<0.01)). Milk samples collected from Galway and Roscommon had a lower mean iodine concentration than those from Derry/Londonderry (p<0.05). Milk intake was positively associated with UIC (p<0.001). Conclusions This is the largest survey of its kind on the island of Ireland, which currently has no iodine fortification programme. Overall, the results suggest that this young female population sits at the low end of sufficiency, which has implications if, in future, they enter pregnancy with borderline status.