A Cost-Effectiveness Study of Animal Disease Eradication Strategies: Foot-and-Mouth Disease in Ireland

The primary focus of this poster paper is to evaluate the cost-effectiveness of alternative control strategies for a number of simulated outbreaks of Foot-and-Mouth disease (FMD) in four agriculturally diverse Irish regions, examining for the first time, the potential role of emergency vaccination in the country. With the increasing threat of transboundary animal diseases due to globalisation, wider market integration and increased animal movement it is important that such an evaluation of control and eradication strategies be undertaken and contingency plans be put in place. The new EU Directive (2003/85/EC) on FMD control permits the use of emergency vaccination as part of an FMD control strategy. The slaughter of infected animals and "dangerous contacts" (susceptible animals on epidemiologically linked holdings) remains the principal tool for tackling an outbreak, but the potential use of vaccination as an adjunct to the basic culling policy is now being considered. Using an integrated approach, combining an epidemiological model and an economic model, alternative control strategies are compared here during hypothetical outbreaks using a computer-simulation model and their cost-effectiveness assessed. The study provides outputs in terms of a range of epidemiological, economic and resource requirement measures under a wide range of different scenarios for each of the alternative control strategies.Foot-and-Mouth disease, control strategies, transboundary animal diseases, emergency vaccination, computer simulation, cost-effectiveness, Livestock Production/Industries, Q1, Q17, Q58,

Foot-and-Mouth Disease control costs compared: An Irish case study.

The primary objective of this paper is to evaluate alternative control strategies for a number of simulated outbreaks of Foot-and-Mouth Disease (FMD) in four agriculturally diverse Irish regions, examining for the first time, the potential role of emergency vaccination in the country. The recent EU Directive (2003/85/EC) on FMD control permits the use of emergency vaccination as part of an FMD control strategy. While the slaughter of infected animals and dangerous contacts (susceptible animals on epidemiologically linked holdings) remains the principal tool for tackling an outbreak, the potential use of vaccination as an adjunct to the basic culling policy is now being considered. Using an integrated approach, combining epidemiological and economic modules, the alternatives of stamping-out both alone and in conjunction with emergency vaccination are examined using hypothetical outbreaks and their control costs compared. Overall, it cannot be said, a priori, that one control option is better than the other. Choice of control strategy would appear to be highly dependent on herd density, production type and other region specific issues. This analysis has focused on control costs only; taking wider economy costs into account may however change this overall conclusion.Foot-and-Mouth disease, alternative control strategies, transboundary animal diseases, emergency vaccination, Livestock Production/Industries, Q1, Q17, Q58,

Hepatitis C Diagnosis and Treatment, Impact on Engagement and Behaviour of People Who Inject Drugs, a service evaluation, the Hooked C project

There is emerging evidence that Hepatitis C (HCV) treatment engagement is associated with change in drug behaviours and reduced drug-related death rates among people who inject drugs (PWID). The project aims to investigate whether HCV diagnosis and treatment engagement reduces all-cause mortality and drug-related death, and whether any effect is dependent on treatment regimen and intensity of engagement with staff. Case-control studies comparing: PWID with active HCV infection (PCR positive) to PWID HCV infected but spontaneously resolved (PCR negative); PCR-positive patients who engaged with treatment services to nonengagers; and patients who received interferon vs direct-acting antiviral (DAA) based treatment. No differences in risk of all-cause mortality or drug-related death between PCR-negative controls and PCR-positive cases were detected. The odds of all-cause mortality was 12.2 times higher in nonengaging persons compared to treatment engaging cases (aOR 12.15, 95% CI 7.03-20.99, P < .001). The odds of a drug-related death were 5.5 times higher in nonengaging persons compared with treatment engaging cases (aOR 5.52, 95% CI 2.67- 11.44, P < .001). No differences in risk of all-cause mortality or drug-related death between interferon-treated cases and DAA-treated controls were detected. HCV treatment engagement is significantly protective against all-cause mortality and drug-related death. This engagement effect is independent of treatment regimen, with the introduction of DAA therapies not increasing risk of drug-related death, suggesting intensity of HCV therapy provider interaction is not an important factor

A systematic review and meta-analysis of community and primary-care-based hepatitis C testing and treatment services that employ direct acting antiviral drug treatments

Background Direct Acting Antiviral (DAAs) drugs have a much lower burden of treatment and monitoring requirements than regimens containing interferon and ribavirin, and a much higher efficacy in treating hepatitis C (HCV). These characteristics mean that initiating treatment and obtaining a virological cure (Sustained Viral response, SVR) on completion of treatment, in non-specialist environments should be feasible. We investigated the English-language literature evaluating community and primary care-based pathways using DAAs to treat HCV infection. Methods Databases (Cinahl; Embase; Medline; PsycINFO; PubMed) were searched for studies of treatment with DAAs in non-specialist settings to achieve SVR. Relevant studies were identified including those containing a comparison between a community and specialist services where available. A narrative synthesis and linked meta-analysis were performed on suitable studies with a strength of evidence assessment (GRADE). Results Seventeen studies fulfilled the inclusion criteria: five from Australia; two from Canada; two from UK and eight from USA. Seven studies demonstrated use of DAAs in primary care environments; four studies evaluated integrated systems linking specialists with primary care providers; three studies evaluated services in locations providing care to people who inject drugs; two studies evaluated delivery in pharmacies; and one evaluated delivery through telemedicine. Sixteen studies recorded treatment uptake. Patient numbers varied from around 60 participants with pathway studies to several thousand in two large database studies. Most studies recruited less than 500 patients. Five studies reported reduced SVR rates from an intention-to-treat analysis perspective because of loss to follow-up before the final confirmatory SVR test. GRADE assessments were made for uptake of HCV treatment (medium); completion of HCV treatment (low) and achievement of SVR at 12 weeks (medium). Conclusion Services sited in community settings are feasible and can deliver increased uptake of treatment. Such clinics are able to demonstrate similar SVR rates to published studies and real-world clinics in secondary care. Stronger study designs are needed to confirm the precision of effect size seen in current studies. Prospero: CRD42017069873

Sustainability levels in Irish dairy farming: a farm typology according to sustainable performance indicators

Feeding the world’s population in a sustainable manner is one of the key challenges facing the future of global agriculture. The recent removal of the milk quota regime in the European Union has prompted an expansionary phase in dairy farming, especially in Ireland. Achieving this expansion in a sustainable manner is crucial to the long-term survival and success of the Irish dairy sector. In this paper we examine the sustainability of Irish dairy farming, defining ‘sustainability’ as economically profitable, environmentally friendly and socially efficient. A typology of Irish dairy farms has been created using data on profitability, environmental efficiency and social integration derived from the Teagasc National Farm Survey. Economic, social and environmental performance indicators were determined and aggregated and then used in a multivariate analysis for the identification and classification of farm clusters. The purpose of this study to classify Irish dairy farms using performance indicators, thereby, assisting policy makers in identifying patterns in farm performance with a view to formulating more targeted policies. Two of the three clusters elicited from the analysis were similar in regards to their respective indicator scores. However, the remaining cluster was found to perform poorly in comparison. The results indicate a clear distinction between ‘good’ and ‘weak’ performers, and the positive relationship between the economic, environmental and social performance of Irish dairy farms is evident

A multicomponent holistic care pathway for people who use drugs in Tayside, Scotland

Background: People Who Use Drugs (PWUD) are at high risk of non-fatal overdose and other drug-related harms. The United Kingdom drugs policy landscape makes it challenging to support those at risk. Tayside, in East Scotland, has a sizeable population at risk of drug-related harms. In 2021, the National Health Service implemented a care pathway for PWUD to provide multidimensional healthcare interventions. We aimed to quantify drug-related harms; assess wider health and well-being; and understand substance use trends and behaviours, among those engaged in the pathway.Methods: Existing community-embedded blood-borne virus pathways were adapted to provide multiple healthcare assessments over three visits. We undertook an observational cohort study to analyse uptake and outcomes for the initial cohort of PWUD engaged at appointment one.Results: From August 2021–September 2022, 150 PWUD engaged with the pathway. Median age was 39 (34–42) years, 108 (72%) were male, and 124 (83%) lived in deprived areas. Seventy (47%) had been disengaged from healthcare for over a year. Polysubstance use was reported by 124 (83%), 42 (28%) disclosed injecting daily, and 54 (36%) shared equipment. Fifty-four (36%) experienced recent non-fatal overdose, and there were six overdose fatalities (4.1 [1.5–9.0] per 100PY). The offer of take-home naloxone was accepted by 108 (72%). Fourteen (9%) were diagnosed with Hepatitis C and two (1%) with HIV. Renal, hepatological, and endocrine impairment were observed among 30 (20%), 23 (15%), and 11 (7%), people respectively. Ninety-six (65%) had high risk of clinical depression. Forty-eight (32%) declined Covid-19 vaccination.Conclusion: The pathway engaged PWUD with high exposure to recent non-fatal overdose and other drug-related harms, alongside co-morbid health issues. Our results suggest multi-dimensional health assessments coupled with harm reduction in community settings, with appropriate linkage to care, are warranted for PWUD. Service commissioners should seek to integrate these assessments where possible

Can technology help achieve sustainable intensification? Evidence from milk recording on Irish dairy farms

peer-reviewedThis article explores the potential of a farm technology to simultaneously improve farm efficiency and provide wider environmental and social benefits. Identifying these ‘win-win-win’ strategies and encouraging their widespread adoption is critical to achieve sustainable intensification. Using a nationally representative sample of 296 Irish dairy farms from 2015, propensity score matching is applied to measure the impact of milk recording on a broad set of farm sustainability indicators. The findings reveal that the technology enhances economic sustainability by increasing dairy gross margin and milk yield per cow. Furthermore, social sustainability is improved through a reduction in milk bulk tank somatic cell count (an indicator of animal health and welfare status). Conversely, milk recording (as it is currently implemented) does not impact farm environmental sustainability, represented by greenhouse gas emission efficiency. While the study shows that milk recording is a ‘win-win’ strategy, ways of improving current levels of utilisation are discussed so that milk recording achieves its ‘win-win-win’ potential in the future.Teagasc Walsh Fellowship Schem

The impact of long-term land leases on farm investment: Evidence from the Irish dairy sector

The European Union milk quota abolition in 2015 resulted in rapid dairy farm expansion across many Member States. Continued production growth requires both capital and herd investment with secure access to land resources being important for new and expanding farmers. As land sales and rental remain low in Ireland, tax incentives to encourage long-term land rental were increased in 2015. This paper assesses the influence of the length of land leases on dairy farm investment using farm-level data from 2015 to 2018 in the context of low levels of land sales and land rental, and liberal market regulations in Ireland. We find a positive association between lease lengths and both the probability and level of capital investment which is particularly important for farmers with a high portion of land rented in. We find that herd investment is not influenced by the duration of land leases. Our findings call for an extension of policies that encourage land rental on secure leases, especially for young farmers, to increase certainty and support growth in the industry

Big issues for a small technology: consumer trade-offs in acceptance of nanotechnology in food

Nanotechnology offers many potential applications across the supply chain which could result in a more sustainable agriculture and food system. However, considerable challenges still exist in realising its potential, including consumer acceptance. This research examines consumer perspectives on two different nanotechnology applications (in packaging for chicken fillets and in cheese) using conjoint analysis. A face-to-face survey of 1046 Irish adults was undertaken. It finds that technology has a significant impact on consumer food choices (higher levels of acceptance with traditional technology rather than nanotechnology), that different applications of a technology can result in varying levels of acceptance (higher acceptance for nanotechnology in packaging of chicken fillets rather than in the cheese product) and that offering salient benefits (e.g. health or lower price) can off-set technology concerns in some but not all instances. Differences amongst consumer segments also exist with price having low utility for “health focused consumers” but having high utility for “conventional consumers”