Voluntary Program Research Articles

S86 - Changes in Opioid and Other Analgesic Prescribing Following Voluntary and Mandatory Prescription Drug Monitoring Program Implementation: A Time Series Analysis

S86 - Changes in Opioid and Other Analgesic Prescribing Following Voluntary and Mandatory Prescription Drug Monitoring Program Implementation: A Time Series Analysis

A sub-national HIV epidemic appraisal in Kenya: a new approach for identifying priority geographies, populations and programmes for optimizing coverage for HIV prevention.

The HIV Prevention 2025 Roadmap, developed by UNAIDS, recommends the adoption of a precision prevention approach focused on priority populations and geographies. With reduction in new HIV acquisitions in many countries, designing a differentiated HIV prevention response, using a Programme Science approach, based on the understanding of the epidemic and transmission dynamics at a sub-national level, is critical. To support strategic planning, an epidemic appraisal at the sub-national level across 47 counties, with the 2019 population ranging from 0.14 million in Lamu to 4.40 million in Nairobi City, was conducted in Kenya using several existing data sources. Using 2021 Spectrum/EPP/Naomi model estimates of national and sub-national HIV incidence and prevalence, counties with high HIV incidence and prevalence were identified for geographic prioritization. The size of local key population (KP) networks and HIV prevalence in key and general populations were used to define epidemic typology and prioritize populations for HIV prevention programmes. Analysis of routine programme monitoring data for 2021 was used to assess coverage gaps in HIV prevention programmes, including prevention of vertical transmission, anti-retroviral therapy, KP programmes, adolescent girls and young women programme, and voluntary male medical circumcision programme. Ten counties with more than 1000 incident acquisitions in 2021 accounted for 57% of new acquisitions. Twenty-four counties were grouped into the concentrated epidemic type-due to their low prevalence in the general population, high prevalence in KPs and relatively higher density of female sex workers and men who have sex with men populations. Four counties reflected a generalized epidemic, where HIV prevalence was more than 10% and 30%, respectively, among the general and key populations. The remaining 19 counties were classified as having mixed epidemics. Gaps in programmes were identified and counties where these gaps need to be addressed were also prioritized. The HIV burden in Kenya is unevenly distributed and hence the mix of prevention strategies may vary according to the epidemic typology of the county. Prioritization of programmes based not only on disease burden and epidemic typology, but also on the prevailing gaps in coverage for reducing inequities is a key aspect of this appraisal.

T96 - Changes in Opioid Agonist Treatment Initiation Following Voluntary and Mandatory Prescription Drug Monitoring Program Implementation: A Time Series Analysis

T96 - Changes in Opioid Agonist Treatment Initiation Following Voluntary and Mandatory Prescription Drug Monitoring Program Implementation: A Time Series Analysis

Assessing the efficacy of EU greenwashing directive: A study of European airlines’ voluntary carbon offset programs

This study evaluates the authenticity, verifiability, and alignment of Voluntary Carbon Offset (VCO) claims made by eighteen European airlines, aligning them with proposed EU regulations specifically targeting greenwashing practices. Our analysis focuses on four key components within VCO programs: measurement, integrity, significance, and alignment. Our findings reveal that European airlines are engaging in greenwashing practices in their VCO programs. The most compelling evidence lies in the insignificance and misalignment of these programs, indicating they are implemented without substantial impact on the airlines' mitigation efforts and are not integrated into their strategies. It is essential to clarify that this research does not delve into the intent behind greenwashing practices but rather aims to shed light on the potential for consumer misperception resulting from such practices. Despite some important limitations, the Greenwashing Directive represents a significant step towards enhancing transparency within the environmental sector, aligning closely with established academic frameworks.

Corporate environmentalism and economic performance: examining the effects of ISO 14001 certification on technical efficiency

The ISO 14001 voluntary standard is a blueprint for improving an organization’s environmental record and one of many tools available to address our planet’s ecological challenges. Since its introduction in 1996, adoption of the standard has surged globally, despite its significant costs. We examine the economic benefits to firms of being ISO 14001-certified by exploring whether certification results in a more efficient production process, using a panel of South Korean manufacturing firms and a stochastic frontier model with endogeneity. We find evidence that ISO 14001 certification significantly improves technical efficiency among high-polluting industries, increasing output by an average of 2.7%. This research enriches the empirical literature on voluntary environmental programs by showing that the standard improves technical efficiency among manufacturing firms. This may account for the popularity of the standard in South Korea, a global leader in manufacturing and exports, where its effects on efficiency have not been empirically examined.

Flushing Out Homeowner Perceptions to Improve Voluntary Septic to Sewer Conversion With Social Marketing

Background Septic systems are recognized as a contributor to water quality degradation. Septic to sewer conversion programs are being implemented to mitigate nutrient pollution but success of voluntary programs is dependent on homeowner participation. The purpose of this study was to identify elements of potential social marketing strategies that could advance the voluntary adoption of septic to sewer conversion programs. Focus of the Article This study used formative survey research to assess residents’ knowledge, attitudes, and perceived benefits of and barriers to septic systems conversion in Florida, USA to inform future interventions promoting this major, costly home infrastructure change that reduces wastewater nutrient contamination. Research Question This study attempts to answer the following questions: (1) Does septic system conversion status (mandatory vs. voluntary) influence homeowners’ knowledge, attitudes, and perceived benefits and barriers to septic to sewer conversion? (2) What social marketing variables are the best predictors of attitude about septic to sewer conversion? Importance to the Social Marketing Field In contrast to inexpensive, repeated habits which are the target of many social marketing campaigns, costly one-time behaviors have been minimally explored by social scientists and social marketers. This study demonstrates how social marketing research can be applied to advance the adoption of costly, one-time infrastructure improvements, with septic to sewer conversions serving as the study context. There are substantial opportunities for social marketers to support local government and other organizations in their promotion of major technologies, including, but not limited to septic system conversions. Methods 518 adult Florida residents who were also septic system owners completed an online survey instrument that assessed subjective and objective knowledge, attitudes about septic to sewer conversion, and motivators and barriers to conversion. Results Septic system homeowners are largely supportive of septic conversion programs; however, the greatest perceived benefits are personal and not associated with environmental improvements. Despite many septic to sewer conversion projects being initiated for environmental purposes, behavior change efforts should promote the benefits of conversion as perceived by the homeowner. The primary barrier is the upfront cost, and alternative funding structures should be investigated. Recommendations for Research or Practice This study indicates that target audience outreach is an essential component of the environmental planning process. Considering the costs and complexity of water quality infrastructure projects, environmental management professionals should consider a robust audience-specific social marketing program as part of the implementation and planning process. The findings presented here suggest opportunities for social marketers to partner with environmental management professionals tasked with encouraging septic to sewer conversion or other costly and significant one-time behaviors.

Developing a framework for understanding policy decision-making behaviors in the transition of an HIV prevention program towards sustainability: a case study from Zambia's voluntary medical male circumcision program.

Faced with declining donor funding for HIV, low- and middle-income countries must identify efficient and cost-effective ways to integrate HIV prevention programs into public health systems for long-term sustainability. In Zambia, donor support to the voluntary medical male circumcision (VMMC) program, which previously funded non-governmental organizations as implementing partners, is increasingly being directed through government structures instead. We developed a framework to understand how the behaviors of individual decision-makers within the government could be barriers to this transition. We interviewed key stakeholders from the national, provincial, and district levels of the Ministry of Health, and from donors and partners funding and implementing Zambia's VMMC program, exploring the decisions required to attain a sustainable VMMC program and the behavioral dynamics involved at personal and institutional levels. Using pattern identification and theme matching to analyze the content of the responses, we derived three core decision-making phases in the transition to a sustainable VMMC program: 1) developing an alternative funding strategy, 2) developing a policy for early-infant (0-2 months) and early-adolescent (15-17 years) male circumcision, which is crucial to sustainable HIV prevention; and 3) identifying integrated and efficient implementation models. We formulated a framework showing how, in each phase, a range of behavioral dynamics can form barriers that hinder effective decision-making among stakeholders at the same level (e.g., national ministries and donors) or across levels (e.g., national, provincial and district). Our research methodology and the resulting framework offer a systematic approach for in-depth investigations into organizational decision-making in public health programs, as well as development programs beyond VMMC and HIV prevention. It provides the insights necessary to map organizational development and policy-making transition plans to sustainability, by explaining tangible factors such as organizational processes and systems, as well as intangibles such as the behaviors of policymakers and institutional actors.

May Measurement Month 2021: an analysis of blood pressure screening results from Bangladesh.

Previous studies have shown that among Bangladeshi adults, one-fifth have hypertension. The National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) campaigns in 2017, 2018, 2019, as well as in 2021 as a part of a global initiative aimed at raising awareness of high blood pressure (BP) and to act as a temporary solution to the lack of nationwide screening programmes. This opportunistic screening of voluntary participants aged ≥18 years was carried out from May to July 2021. Data were collected from more than 150 screening sites in all 64 districts in Bangladesh. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the MMM protocol. Data on 28 355 individuals were finally analysed. Among the participants, 17 941 (63.3%) were female. After multiple imputation, 11 194 (39.5%) had hypertension. Among the 11 194 participants with hypertension, 78.8% were aware of having hypertension and 65.6% were on antihypertensive medication. Among 11 194 participants with hypertension, 7340 participants (65.6%) were on antihypertensive medication and 43.8% had controlled BP (<140/90 mmHg). Of those on antihypertensive medication, 66.8% had controlled BP. A voluntary BP screening programme can identify significant numbers of people with raised BP and thus contributes importantly to the prevention of cardiovascular diseases.

Exploring the opportunities in circular design as an affordable housing solution in Nigeria

Abstract The shortage of adequate housing is caused by global challenges such as urbanisation, economic instability, pandemics, and displacements. Additionally, the building sector is resource-intensive, leading to the emergence of the circular economy (CE) that is focused on resource efficiency. The design stage plays a central role in the CE model. However, circular housing design (CHD) in Nigeria has not been thoroughly explored. This study examined the opportunities for implementing CHD in Nigeria. Through a desk review approach, relevant data from the critical review of selected articles from reputable databases in the last five years were synthesized and incorporated into the study. The findings revealed that the adoption of CHD in Nigeria can assist in achieving affordability, decarbonisation, climate change mitigation, improving environmental value, energy optimisation, resource efficiency, and urban mining. More specifically, it will stimulate sustainability in the housing sector, digitalisation, technical expertise development, policies and regulations, land provision, coordination and collaboration, local voluntary stewardship programme, and new market opportunities in housing delivery in Nigeria. There is a need to develop technical skills in CHD through knowledge sharing among design professionals via multi-stakeholder collaborations and investment in technologies, as well as adopting integrated circular project delivery methods in the supply chain.

Outcomes of sugar reduction policies, United Kingdom of Great Britain and Northern Ireland.

Poor diets are the major cause of death and disease globally, driving high levels of obesity and noncommunicable diseases. Cheap, heavily marketed, ultra-processed, energy-dense and nutrient-poor food and drinks that are high in fat, sugar and salt play a major role. The high-sugar content of these products leads to consumption levels much higher than recommended. The World Health Organization recommends that sugar intake should be reduced to just 5% of energy intake by using fiscal policies and food and drink reformulation strategies. Over the previous decade, the government of the United Kingdom of Great Britain and Northern Ireland has implemented several policies aimed at reducing sugar intake. We compare the soft drinks industry levy and the sugar reduction programme, examining how differences in policy design and process may have influenced the outcomes. Success has been mixed: the mandatory levy achieved a reduction in total sugar sales of 34.3%, and the voluntary reduction programme only achieved a 3.5% reduction in sugar levels of key contributors to sugar intake (despite a target of 20%). Both policies can be improved to enhance their impact, for example, by increasing the levy and reducing the sugar content threshold in the soft drinks industry levy, and by setting more stringent subcategory specific targets in the sugar reduction programme. We also recommend that policy-makers should consider applying a similar levy to other discretionary products that are key contributors to sugar intake. Both approaches provide valuable learnings for future policy in the United Kingdom and globally.

#1192 Impact of intradialytic exercise on all-cause mortality in frail patients undergoing hemodialysis: a three-year multicenter cohort study

Abstract Background and Aims Frailty prevalence is notably high among older hemodialysis patients, correlating with poorer prognoses. Prior smaller-scale studies have underscored the benefits of various exercise interventions in individuals with Chronic Kidney Disease and those receiving dialysis treatments. Addressing frailty in older hemodialysis patients by exercise therapy is crucial for healthcare professionals aiming to enhance patient outcomes. Despite this, a standardized exercise therapy protocol for this demographic has not been broadly implemented in clinical practice. Our study sought to evaluate the impact of intradialytic resistance exercise programs on the prognosis of frail individuals undergoing hemodialysis. Method This retrospective, multicenter, non-randomized clinical trial encompassed 2006 participants (mean age 70.1±11.7 years) from 17 outpatient clinics within the Kaikoukai Medical Group. Enrollment spanned from April to December 2018, with patients stratified according to baseline frailty levels, determined by the Japanese Frailty Criteria for the Diagnosis of Frailty in the Elderly. In this study, patients meeting the criteria for frailty or pre-frailty, as defined by the Japanese Criteria for Health and Social Services (J-CHS), were collectively classified as 'frail’. Participants were invited to join a voluntary exercise program during dialysis, which included stretching and four types of resistance exercises using elastic tubes. The cohort was divided into four groups based on their frailty status and participation in the exercise program. Patient outcomes were monitored until either death or the study's conclusion in December 2021. Kaplan-Meier and log-rank analyses were utilized to assess prognostic differences among the groups, with significance levels adjusted using the Bonferroni correction. Ethical approval was granted by the Nagoya Kyoritsu Hospital's ethical committee. Results The study comprised 112 non-frail exercising, 398 frail exercising, 205 non-frail non-exercising, and 1287 frail non-exercising patients. Over the study period (median 25 months), mortality was recorded in 338 (16.9%) patients, including 8 (7.1%) non-frail exercising, 50 (12.6%) frail exercising, 16 (7.8%) non-frail non-exercising, and 264 (20.5%) frail non-exercising participants. Prognostic analysis revealed that the frail non-exercising group had a significantly poorer prognosis than both the non-frail exercising and non-frail non-exercising groups, as well as the frail exercising group (p&amp;lt;0.05). Conclusion This investigation is pioneering in establishing a link between intradialytic resistance exercise interventions and prognosis in frail patients. The findings indicate that, although frail patients inherently face a more challenging prognosis, participation in intradialytic exercise can yield substantial improvements. Therefore, clinicians are encouraged to advocate for exercise therapy as a means to enhance prognosis in frail patients undergoing hemodialysis.

Challenges in organising blood donation camps at remote military base and its impact on blood component quality: A unique helicopter-based whole blood transport experience

BackgroundThere is a huge gap between safe blood supply and clinical demand in India and voluntary blood donation camps (BDSs) are vital to address this gap. The study evaluates the challenges faced in organizing remote setting voluntary BDCs and assess the impact of helicopter-flight on the quality of the whole blood units (WBU) and blood components (BC) prepared. MethodsThis is an observational study in which two voluntary BDCs were organised in remote military-based setting in 2021. Pre-camp activities, camp organisation, community engagement, and transportation logistics were evaluated. All WBU collected were exposed to helicopter-flight for transportation to the main blood centre with cold-chain maintenance. Impact of helicopter-flight on WBU and BC prepared was evaluated by performing extensive quality control (QC) testing. ResultsA total of 123 WBU were collected in both camps with transportation time of 160 and 150 min for camp-1 and −2 respectively. 123 PRBC, 22 BC-PC, 75 FFP and 48 CRYO units were prepared in-total within recommended time-limits. No haemolysis was detected in WBU, and all BC met QC criteria as per National guidelines. ConclusionsProper pre-camp planning, prior screening of donors, clear collection process policy, feasibility of efficient transport system, regular communication, and maintenance of cold-chain are crucial factors in determining the success of remote BDCs and quality of BC. Our study provides practical recommendations for policymakers, military healthcare providers, transfusion medicine specialists and public health professionals to enhance the effectiveness and sustainability of voluntary blood donation programs in remote settings.

Formal vs. Informal Voluntary Disclosure Policies

Abstract Tax administrations have long grappled with the question of how noncompliant taxpayers should be allowed to correct their tax affairs voluntarily. While many jurisdictions have adopted various voluntary disclosure programs, several countries—including some of the world’s largest economies—have not done so. This Article examines the voluntary disclosure practices in twenty-five countries that do not have voluntary disclosure programs. It finds that the tax authorities in these jurisdictions frequently follow informal voluntary disclosure practices that operate as de facto substitutes for formal policies. In some countries, informal voluntary disclosure practices coexist alongside formal schemes. In light of these findings, this Article explores the tax policy considerations concerning the choice between formal and informal voluntary disclosure policies, and shows that formal schemes have several advantages over informal practices.

A prospective observational study examining weight and psychosocial change in adolescent and adult eating disorder inpatients admitted for nutritional rehabilitation using a high-energy re-feeding protocol

BackgroundHigh-energy re-feeding protocols are increasingly utilised for nutritional rehabilitation in adolescents with anorexia nervosa (AN), however, concern persists that adults with AN may be at greater risk of developing complications. In addition, research on psychological outcomes of eating disorder (ED) inpatient treatment programs, and outcomes of high-energy protocols in avoidant restrictive food intake disorder (ARFID) and bulimia nervosa (BN), is limited. This study of an ED inpatient program using a high-energy protocol, compared changes in weight and psychosocial outcomes between adolescents and adults, and identified medical risk factors associated with deviation from the protocol.MethodThis prospective observational study took place in a voluntary ED treatment program in a private hospital. Weight, height, and psychosocial questionnaires (ED Examination-Questionnaire, Depression Anxiety Stress Score, Clinical Impairment Assessment and AN/BN Stage of Change) were collected from consenting adolescents (16–20 years) and adults (> 20 years) on admission and discharge. Medical tolerance to the high-energy protocol was assessed daily. Independent samples t-tests and paired samples t-tests were applied to normally distributed data, and Mann–Whitney U tests and Wilcoxon signed-rank tests to skewed data. P-values < 0.05 were considered significant statistically.ResultsNinety-seven participants were recruited. The majority (n = 91, 94%) were female and most (n = 80, 83%) had AN. Forty-two (43%) were adolescents and 55 (57%) were adults. In participants with AN, weight change (Δ) was significant [median Δ 8.0 (interquartile range (IQR) 4.3) kg]. There was no difference in rate of weight change between adolescents and adults with AN [mean Δ 1.8 (standard deviation (SD) 0.5) kg/week vs. Δ 1.8 (SD 0.6) kg/week; p = 0.841, respectively]. One (1%) participant with AN did not tolerate the high-energy protocol due to oedema. Participants achieved positive change in psychosocial questionnaire scores (p < 0.001) after the the specialist ED program, with no difference between adolescents and adults (p > 0.05).ConclusionsThis voluntary ED treatment program using a high energy re-feeding protocol was effective in achieving positive weight and psychological change for adolescents and adults with minimal adverse events. This indicates that the specialist ED program has both nutritional and psychological benefits.

English-Medium Master's Degree Programs at a Saudi University: Attitudes, Experiences, and Obstacles

English-medium instruction has become a prevalent strategy for increasing the internationalization opportunities of Saudi universities and the international employability of their graduates. The findings of an interview (12 professors and 30 students) and an observation of three established Science, Social Science, and Engineering master's degree programs at a major Saudi university in Riyadh are presented in this article. In order to facilitate the implementation of English-taught master's degree programs, the purpose of this study was to identify the perspectives, experiences, and obstacles of higher education stakeholders regarding English-medium instruction. Findings showed that English-medium instruction is generally preferred by both professors and students. Although the need for support measures was not as high as expected, certain challenges remain, which can be addressed through focused initiatives. Notable issues include stakeholder unhappiness, a high workload for students, varying degrees of prior knowledge among students. The research highlights how crucial it is to include English for Specific Purposes (ESP) instruction in the curriculum and recommends adding more tools and resources to support teacher development. These measures could involve voluntary participation and incentive programs.

Virtual pair programming and online oral exams: effects on social interaction, performance, and academic integrity in a remote computer programming course

ABSTRACT Background and context Pair programming and oral exams were deployed in tandem in a remote undergraduate computer programming course to promote social interaction and enhance learning. Objectives We investigate their impact on social interactions, sense of connection, academic performance, and academic integrity within a virtual learning environment, and explore the dynamics of student collaboration in the context of voluntary pair programming. Method Students’ coding activities, pairing preferences, and performance were survey responses were recorded and analyized. Findings First and second year students were more likely to participate in virtual pair programming than their more senior classmates. Willingness to pair program strongly correlated with GPA. Partner changes were infrequent. 20–40% of students pair programmed per assignment. Oral exam scores positively correlated with other course scores. Surveys indicated that virtual pair programming and oral exams positively impacted learning, sense of community, and academic integrity. Implications The study offers perspectives on how these practices can be leveraged to foster inclusive learning, meaningful discourse, peer collaboration, and student-faculty relationships, with a positive effect on student motivation and academic integrity.

Randomised pilot and feasibility trial of a group intervention for men who perpetrate intimate partner violence against women

BackgroundThere is a need for robust evidence on the effectiveness and cost-effectiveness of domestic abuse perpetrator programmes in reducing abusive behaviour and improving wellbeing for victim/survivors. While any randomised controlled trial can present difficulties in terms of recruitment and retention, conducting such a trial with domestic abuse perpetrators is particularly challenging. This paper reports the pilot and feasibility trial of a voluntary domestic abuse perpetrator group programme in the United Kingdom.MethodsThis was a pragmatic individually randomised pilot and feasibility trial with an integrated qualitative study in one site (covering three local-authority areas) in England. Male perpetrators were randomised to either the intervention or usual care. The intervention was a 23-week group programme for male perpetrators in heterosexual relationships, with an average of three one-to-one sessions, and one-to-one support for female current- or ex-partners delivered by third sector organisations. There was no active control treatment for men, and partners of control men were signposted towards domestic abuse support services. Data were collected at three-monthly intervals for nine months from male and female participants. The main objectives assessed were recruitment, randomisation, retention, data completeness, fidelity to the intervention model, and acceptability of the trial design.ResultsThis study recruited 36 men (22 randomly allocated to attend the intervention group programme, 14 to usual care), and 15 current- or ex-partners (39% of eligible partners). Retention and completeness of data were high: 67% of male (24/36), and 80% (12/15) of female participants completed the self-reported questionnaire at nine months. A framework for assessing fidelity to the intervention was developed. In interviews, men who completed all or most of the intervention gave positive feedback and reported changes in their own behaviour. Partners were also largely supportive of the trial and were positive about the intervention. Participants who were not allocated to the intervention group reported feeling disappointed but understood the rationale for the trial.ConclusionsIt was feasible to recruit, randomise and retain male perpetrators and female victim/survivors of abuse and collect self-reported outcome data. Participants were engaged in the intervention and reported positive benefits. The trial design was seen as acceptable.Trial registrationISRCTN71797549, submitted 03/08/2017, retrospectively registered 27/05/2022.

A Framework for Assessing Food Baskets Based on Water and Carbon Footprints

The composition of food baskets can significantly influence the water consumption rate and society’s environmental impact. This study evaluates the sustainability of Iran’s food and nutrition security by evaluating five food baskets using water and carbon-footprint indices. These food baskets are the common Iranian food basket (CIFB), the vegetarian food basket (VFB), the Ministry of Health desired food basket (MHDFB), the Swiss Society for Nutrition food basket (SSNFB), and the Mediterranean food basket (MFB). This study also examines the role of Iran’s agricultural sector under the Paris Climate Change Agreement (COP21). The TOPSIS multi-criteria decision-making method was used to identify the most desirable food basket. The results of this study show that the VFB could be the most desirable alternative to the CIFB. Replacing the CIFB with the VFB causes a 10% and 21% lower water and carbon footprint, respectively. From a 30-year perspective (around 2050), choosing the VFB would reduce the blue water footprint by 19.7 BCM and the gray water footprint by 3.6 BCM compared to the CIFB. According to the provisions of COP21 regarding Iran’s voluntary program to reduce greenhouse gas emissions, the agricultural sector will be one of the sources of greenhouse gas emissions that will face an upward trend. Hence, to adhere to this voluntary commitment, these emissions should be reduced by changing the CIFB to the VFB or reducing emissions in other sectors, such as industry. Choosing the VFB can reduce 10.7 million tons of CO2 emissions, which can be a significant step for the agricultural sector in Iran in reducing greenhouse gas emissions. Overall, considering the characteristics of farm products (water and carbon footprints) in Iran, a country located in a semi-arid climate, the VFB is recommended.

Correlation of lesion severity with bacterial changes in Treponeme-Associated Hoof Disease from free-roaming wild elk (Cervus canadensis)

BackgroundTreponeme-Associated Hoof Disease (TAHD) is a polybacterial, multifactorial disease affecting free-ranging wild elk (Cervus canadensis) in the Pacific Northwest. Previous studies have indicated a bacterial etiology similar to digital dermatitis in livestock, including isolation of Treponema species from lesions. The lesions appear to progress rapidly from ulcerative areas in the interdigital space or along the coronary band to severe, ulcerative, necrotic, proliferative lesions under-running the hoof wall, perforating the sole, and contributing to hoof elongation, deformity, and overgrowth. Eventually the lesions undermine the laminal structure leading to sloughing of the hoof horn capsule. The objective of this study was to characterize the bacterial communities associated with hoof lesions, which were categorized into 5 stages or disease grade severities, with 0 being unaffected tissue and 4 being sloughed hoof capsule. We also wanted to determine if the etiology of TAHD through morphological changes was dominated by Treponema, as observed in hoof diseases in livestock.ResultsThe bacterial 16S rRNA gene was sequenced from 66 hoof skin biopsy samples representing 5 lesion grades from samples collected by Washington Department of Fish and Wildlife as part of a voluntary hunter program. Analysis of the relative abundance of bacterial sequences showed that lesions were dominated by members of the bacterial phyla Proteobacteria, Firmicutes, Spirochaetes, Bacteroidetes and Actinobacteria. In lesion samples, members of the genus Treponema, Porphyromonas, and Mycoplasma increased with lesion severity. Association analysis indicated frequent identification of Treponema with Porphyromonas, Bacteroides and other anaerobic Gram-positive cocci.ConclusionsThe bacterial 16S rRNA gene sequencing confirmed the presence of Treponema species at all stages of TAHD lesions, treponeme specie-specific PCR and histopathology, indicating that the morphological changes are a continual progression of disease severity with similar bacterial communities. Association and abundance of these other pathogenic genera within lesions may mean synergistic role with Treponema in hoof disease pathogenesis. Characterizing bacteria involved in lesion development, and their persistence during disease progression, provides evidence for science-based management decisions in TAHD infected elk populations.

Modeling the implications of policy reforms on pesticide risk for Switzerland

Growing public awareness of the negative effects of pesticides on the environment, ecosystems, and human health has led governments to set targets for reducing pesticide risk. Switzerland introduced in 2023 two new policy measures to reduce pesticide risk by 50 % by 2027: (1) voluntary direct payment programs supporting pesticide-reduced and pesticide-free but non-organic cropping systems for most crops on arable land, and (2) restrictions of harmful pesticides for farmers managing under Swiss cross-compliance standards. This study aims to (1) develop a method to assess pesticide risk on a national scale and (2) carry out an ex-ante impact assessment to predict whether these policies can effectively reduce pesticide risks in Switzerland. Therefore, we introduced crop-specific pesticide quantities and pesticide risk scores into a sample of 1907 bio-economic farm optimization models. The models were used to predict farmers' adoption decisions regarding voluntary direct payment programs from 2019 to 2030. By combining the bio-economic farm optimization models with an agent-based modeling approach, we assessed the evolution of pesticide-related risks at the national level. Simulations for pesticide risk from 2019 to 2022 reflected the observed pesticide risk monitored by the Swiss government. In surface waters and semi-natural habitats, achieving the target depends on reducing pyrethroids, a class of insecticides with high-risk potential. Further, we highlight significant uncertainty in projecting the risk potential for surface waters and semi-natural habitats due to uncertainty about the amounts of pyrethroid used for different crops. The results underline the need for comprehensive datasets on pesticide use in Switzerland.