A One Health Framework for the Evaluation of Rabies Control Programmes: A Case Study from Colombo City, Sri Lanka

<div><p>Background</p><p>One Health addresses complex challenges to promote the health of all species and the environment by integrating relevant sciences at systems level. Its application to zoonotic diseases is recommended, but few coherent frameworks exist that combine approaches from multiple disciplines. Rabies requires an interdisciplinary approach for effective and efficient management.</p><p>Methodology/Principal Findings</p><p>A framework is proposed to assess the value of rabies interventions holistically. The economic assessment compares additional monetary and non-monetary costs and benefits of an intervention taking into account epidemiological, animal welfare, societal impact and cost data. It is complemented by an ethical assessment. The framework is applied to Colombo City, Sri Lanka, where modified dog rabies intervention measures were implemented in 2007. The two options included for analysis were the control measures in place until 2006 (“baseline scenario”) and the new comprehensive intervention measures (“intervention”) for a four-year duration. Differences in control cost; monetary human health costs after exposure; Disability-Adjusted Life Years (DALYs) lost due to human rabies deaths and the psychological burden following a bite; negative impact on animal welfare; epidemiological indicators; social acceptance of dogs; and ethical considerations were estimated using a mixed method approach including primary and secondary data. Over the four years analysed, the intervention cost US $1.03 million more than the baseline scenario in 2011 prices (adjusted for inflation) and caused a reduction in dog rabies cases; 738 DALYs averted; an increase in acceptability among non-dog owners; a perception of positive changes in society including a decrease in the number of roaming dogs; and a net reduction in the impact on animal welfare from intermediate-high to low-intermediate.</p><p>Conclusions</p><p>The findings illustrate the multiple outcomes relevant to stakeholders and allow greater understanding of the value of the implemented rabies control measures, thereby providing a solid foundation for informed decision-making and sustainable control.</p></div

Who Pays? Who Benefits? Unfairness in American Health Care

American-style health insurance greatly amplifies price-gouging opportunities for health care providers, who inflate prices both to enrich themselves and to subsidize and expand the nation’s health care enterprise. To the extent that lower- and middle-income Americans with private health coverage pay premiums that go to support and expand the system, they are subject to an unfair (regressive) “head tax” levied by unaccountable entities for ostensibly public but also private purposes. Lower-income premium payers also often pay for costly health coverage designed to suit the economic interests and values of professional and other elites rather than their own. They also appear to get less as a group out of their employers’ health plans than their higher-income coworkers. How the cost burdens and benefits of Americans’ health care are distributed has not been sufficiently recognized as the fundamental issue of social justice that it is - even after the major reform legislation of 2010

Exploring HR Differentiation from Co-Workers’ Perspective:A Deontic Justice Theory Perspective

Providing employees with individualized HR practices has become an important component of HR strategies. Despite the growing prevalence of individualization of HRM, research has overlooked the downside of such practices, in particular from co-workers’ perspective. This is an important omission because research to date has built on the assumption that the impact of HR differentiation on employees not entitled to such practices is either trivial or non-existent. Taking a first step, this research offers a conceptual model that explains how and under which conditions co-workers of a focal employee who is entitled to HR differentiation are likely to support and withdraw their support from the focal employee. Integrating deontic justice theory with research on perceived motivational climate (i.e., performance oriented versus mastery oriented unit climate), the proposed conceptual model underlines that differentiating HR practices is like a double-edged sword and caution is needed when implementing them in a team setting

The Institutional Aims of the Public Healthcare System and Its Ethical-Social Action

In recent years, the reflection on the social role the healthcare company plays has led public opinion, management scholars and the healthcare system themselves to place the concept of ethics at the centre of their attention. Throughout the decades, the doctrine has taken notable steps forward in the definition of the particular version of ethics, that is, business ethics, while at the same time, quite a few healthcare system have begun to equip themselves with instruments for defining and measuring their ethical behaviour (e.g. ethical codes, customer satisfaction tools, complaint handling). Today, in fact, many healthcare systems are fully aware that it is in their best interest to manage their ethics as much as their economy and that it is wrong to consider the commitment of social responsibility within the government only as a purely moral concern (and therefore, in some ways, optional). Today, the healthcare system is given a new role by the society, which stands side by side with the by now “institutional” role of producing goods and services while creating welfare: it thus becomes an organism that must behave more responsible in satisfying human values. It becomes a cell that works in a synergetic manner within the larger macroeconomic system

Folktales and Education: Role of Bhutanese Folktales in Value Transmission

This paper begins by introducing Meme ‘Haylain’ Happiness, a concept drawn from a Bhutanese folktale about an old man, Meme Haylay Haylay, who exchanges his turquoise for a song, and happily returns home singing the song. It questions whether we are ready to pursue happiness in our daily life like Meme Haylay Haylay who had realized that more happiness would flow from singing a song than from guarding the turquoise. The paper then explores the roles of Bhutanese oral tradition in educating children who could not avail themselves of either monastic or modern education. It argues that modern education, which primarily provides secular, pluralistic, egalitarian and market values necessary for running economic, political and legal institutions and the machinery of the modern nation-state is deficient in many ways; it is the oral tradition which fills this gap by inculcating universal, humanistic and Bhutanese values. It also discusses the main functions of Bhutanese folktales which are about trivial events but embedded with multi-layered meanings of great moral and social importance, with experiences drawn from daily life. The common motifs of the tales are chosen to relate them to the daily realities of the Bhutanese people. Lastly, this paper makes some policy recommendations to promote, document, disseminate and study the Bhutanese folktales through the mass media such as the press, radio, TV, internet, and film industry

Beyond Personalization: Research Directions in Multistakeholder Recommendation

Recommender systems are personalized information access applications; they are ubiquitous in today's online environment, and effective at finding items that meet user needs and tastes. As the reach of recommender systems has extended, it has become apparent that the single-minded focus on the user common to academic research has obscured other important aspects of recommendation outcomes. Properties such as fairness, balance, profitability, and reciprocity are not captured by typical metrics for recommender system evaluation. The concept of multistakeholder recommendation has emerged as a unifying framework for describing and understanding recommendation settings where the end user is not the sole focus. This article describes the origins of multistakeholder recommendation, and the landscape of system designs. It provides illustrative examples of current research, as well as outlining open questions and research directions for the field.Comment: 64 page