Let's End HepC: Modelling Public Health Epidemiological Policies Applied to Hepatitis C in Spain

Background: The WHO has defined international targets toward the elimination of hepatitis C by 2030. Most countries cannot be on track to achieve this goal unless many challenges are surpassed. The Let's End HepC (LEHC) tool aims to contribute to the control of hepatitis C. The innovation of this tool combines the modelling of public health policies (PHP) focused on hepatitis C with epidemiological modelling of the disease, obtaining a unique result that allows to forecast the impact of policy outcomes. The model was applied to several countries, including Spain.Methods: To address the stated objective, we applied the “Adaptive Conjoint Analysis” for PHP decision-making and Markov Chains in the LEHC modelling tool. The tool also aims to be used as an element of health literacy for patient advocacy through gamification mechanisms and country comparability. The LEHC project has been conducted in several countries, including Spain. The population segments comprised in the project are: People Who Inject Drugs (PWID), prisoners, blood products, remnant population.Results: A total of 24 PHP related to hepatitis C were included in the LEHC project. It was identified that Spain had fully implemented 14 of those policies to control hepatitis C. According to LEHC's model forecast, the WHO's Hepatitis C elimination goal on reducing the number of patients living with Hepatitis C to 10% can be achieved in Spain by 2026 if current policies are maintained. The model estimates that the total population in Spain, by 2026, is expected to comprise 26,367 individuals living with hepatitis C. Moreover, if the 24 PHP considered for this study are fully implemented in Spain, the elimination goal may be achieved in 2024, with 29,615 individuals living with hepatitis C by that year.Conclusion: The findings corroborate the view that Spain has set great efforts in directing PHP toward Hepatitis C Virus (HCV) elimination by 2030. However, there is still room for improvement, namely in further implementing 10 of the 24 PHP considered for the LEHC project. By maintaining the 14 PHP in force, the LEHC model estimates the HCV elimination in the country by 2026, and by 2024 if further measures are employed to control the disease.

Identification and Evaluation of African Lion (Panthera leo) Cub Welfare in Wildlife-Interaction Tourism

African lion (Panthera leo) cubs are extensively used in South Africa in wildlife-interaction tourist activities. Facilities provide close interaction opportunities, but the welfare impacts on the cubs are unclear. A workshop was held with 15 lion-experienced stakeholders, including government officials, nature conservationists, animal welfare organisations, lion breeders, lion handlers, an animal ethologist, wildlife veterinarian, wildlife rehabilitation specialist and an animal rights advocacy group representative. Individual representatives nominated a range of welfare concerns, and 15 were identified for discussion and prioritisation. The leading welfare concern was a lack of governance and regulation within the industry. Participants agreed on nine non-negotiable practices affecting welfare concerns, which included ethical concerns, such as cubs exiting into the ranching industry (farming of lions for hunting) and the bone trade (lions being slaughtered for their bones, which are exported for lion bone wine) once petting age has passed. Welfare concerns representative of current management practices within the lion cub interaction industry were compared for importance using an online adaptive conjoint analysis survey of 60 stakeholders in the industry. The survey identified the most important welfare concerns to be poor social grouping of cubs, an inability for cubs to choose their own environment and retreat from a forced interaction, a lack of trained and dedicated caretakers, and poor breeding practices. The conjoint analysis survey results produced a value model, which can be used as a tool to score cubs’ welfare in interaction facilities, and it identified unacceptable practices lacking welfare consideration.

Identification of Thoroughbred Racehorse Welfare Issues by Industry Stakeholders

Identifying key welfare issues for thoroughbred racehorses could lead to an improvement in standards. A lack of scientific information on the relative importance of key issues was addressed by soliciting the views of, first, welfare experts in the industry and, second, a broader group of stakeholders, who selected the best welfare options by adaptive conjoint analysis. The experts represented racehorse breeders, veterinarians, trainers, owners, government officials, salespeople, farriers, transporters, and horse re-trainers for post-racing activities. In a focus group meeting, the experts identified fourteen key welfare issues, each with two to four levels that related to common husbandry practices. Then, in an internet survey, 224 stakeholders ranked the issues using adaptive conjoint analysis, in declining importance, as: horsemanship > health and disease > education of the horse > track design and surface > ventilation > stabling > weaning > transport > nutrition > wastage > heat and humidity > whips > environment > gear. Relatively uniform responses to the survey by the different stakeholder groups suggested that there was a common view on what had the biggest impact on welfare. An exception was a greater rating given by women than men to the importance of correct horse nutrition. The rating of importance for welfare of different levels of provision of each issue mostly conformed to the scientific evidence, with the exception of weaning. This understanding of the importance of welfare issues for thoroughbred racehorses could be used to target interventions to the most serious problems.

Integrating public health policies in the epidemiological modeling of hepatitis C with LEHC tool: application in Austria

Summary Background Eliminating hepatitis C requires addressing issues other than medicines or therapies. Public health policies focused on the hepatitis C virus (HCV) must be emphasized and worked to know the impacts on its epidemiologic dynamics. This research aims to provide a tool to evaluate and simulate alternatives by redefining policies meeting specific needs in each country towards the HCV elimination target by 2030. Methods The development of a gamified model with 24 public health policies focused on HCV was conducted to evaluate the impact of measures in the disease epidemiologic dynamics. The Let’s End HepC (LEHC) project encompassed key populations (people who inject drugs [PWID], prisoners, blood products and remnant population) in Austria and other countries, presenting prospects for every year from 2019 to 2030. The LEHC epidemiological model comprised an integrated solution for HCV, with adaptive conjoint analysis (ACA) and Markov chains constituting its main processes. Results Despite Austria’s efforts towards achieving the HCV elimination goal by 2030, the LEHC model forecast quantitative analysis predicts that it is still not enough to meet the target; however, prospects are very optimistic if public health policies are adapted to the country’s needs, being possible to achieve the goal as early as 2026. Conclusion In Austria, the LEHC tool allowed to forecast the HCV elimination year anticipation to 2026, instead of being achieved after 2030. This target will only be valid if adequate management of the 24 public health policies focused on this pathology is further implemented.

The Effect of Values on the Attractiveness of Responsible Employers for Young Job Seekers

Purpose: Empirical studies suggest that corporate social responsibility (CSR) impacts young job seekers’ choices of an employer. Values seem to affect CSR preferences, influencing the felt fit between the person and the organization and hereby the valence of working for that company. This article aims to research in more detail the preference structure of young graduate job seekers. In particular, it seeks to understand whether CSR is important when there is a trade-off between CSR and non-CSR attributes and whether basic value orientations of job seekers have a moderating effect on their employer preferences. Design/methodology/approach: This article used a quantitative approach with a survey sample of 577 German students who were in their last year of study. To gain information on the relative impact of CSR- and non-CSR-related employer characteristics on employer attractiveness, an adaptive conjoint analysis was applied. Correlation analysis and a two-step hierarchical regression were conducted to detect the effects of individual value orientations. Findings: Only a few CSR attributes are relevant for young job seekers compared with other traditional employer attributes. Specific value orientations can be identified as having a moderating effect on CSR preferences. This is particularly the case for value orientations indicating a concern for the welfare of others and the environment positively affect the importance of most CSR attributes while more selfish value orientations have a negative effect. Originality/value: This study sheds light on the relative importance of CSR attributes when compared with non-CSR attributes. Moreover, it relates employee-related preferences to individual value orientations and shows that selected values have a modifying effect on the importance of CSR for job choice.

Modeling the Puzzle of Hepatitis C Epidemiology in Romania: A Pathway to Control

Background and Aims: To combat hepatitis C virus (HCV) and achieve its elimination by 2030, the emphasis should be on public health policies. In this study, we investigated the dynamics of epidemiology of HCV in Romanian risk groups that are characterized by higher occurrence densities with the aid of The Let’s End HepC (LEHC) project. Methods: The LEHC project addressed the modelling of HCV epidemiology, being applied in several countries, one of which is Romania. The model comprised an integrated solution of public health policies focused on the disease, using Adaptive Conjoint Analysis and Markov chains systems. This tool allowed the quantitative evaluation of public health policies‘ impact, for every year until 2030, in five population groups: people who inject drugs (PWID), prisoners, individuals who have received blood products, children at risk for vertical transmission, and the remnant population. Results: It appears that Romania was already making great efforts in the context of public policies, allowing the achievement of HCV elimination by 2028 if current policies were maintained. Through additional work and greater efforts in further implementing public policies, the LEHC model estimated the possibility of anticipating this outcome to 2026. Conclusion: The LEHC model estimated an anticipation of the HCV elimination year in Romania to be 2026 if the twenty-four health policies in the study are fully implemented and consistently maintained over the years.

What Teachers Want: School Factors Predicting Teachers’ Decisions to Work in Low-Performing Schools

Attracting and retaining teachers can be an important ingredient in improving low-performing schools. In this study, we estimate the expressed preferences for teachers who have worked in low-performing schools in Tennessee. Using adaptive conjoint analysis survey design, we examine three types of school attributes that may influence teachers’ employment decisions: fixed school characteristics, structural features of employment, and malleable school processes. We find that teachers express a strong preference for two malleable school processes, administrative support and discipline enforcement, along with a higher salary, a structural feature. Estimates indicate these attributes are 2 to 3 times more important to teachers than fixed school characteristics like prior achievement. We validate our results using administrative data on teachers’ revealed preferences.