European Illegal Puppy Trade and Organised Crime

Organised crime groups’ involvement in illicit markets is a common focus of law enforcement and governments. Drug, weapon, human and wildlife trafficking (and others) are all illegal activities with link to organised crime. This paper explores the overlooked illicit market of puppies. We detail the state of knowledge about the organisation of the UK puppy trade, which includes irresponsible and illegal breeding of puppies throughout Europe and their often-illegal movement into the UK. In 2017, we conducted an analysis of hundreds of online advertisements in Scotland, 12 expert interviews, a stakeholder survey of 53 participants, and 40 focus groups across Great Britain. Our data suggest an organised illicit market running in parallel to the legal trade. We speculate as to whether at some point along the supply chain organised crime groups are responsible for the suffering and death of the puppies and the economic and emotional damage to ‘consumers’. Online monitoring and physical scrutiny at the ports must be improved to reduce non-human animal abuse. People buying puppies must also be made aware that their purchase could be profiting organised crime

The welfare of wildlife: an interdisciplinary analysis of harm in the legal and illegal wildlife trades and possible ways forward

Wildlife trade—both legal and illegal—is an activity that is currently the focus of global attention. Concerns over the loss of biodiversity, partly stemming from overexploitation, and the corona virus pandemic, likely originating from wildlife trade, are urgent matters. These concerns though centre on people. Only sometimes does the discussion focus on the wildlife traded and their welfare. In this article, we make the case as to why welfare is an important component of any discussion or policy about wildlife trade, not only for the interests of the wildlife, but also for the sake of humans. We detail the harm in the trade as well as the current welfare provisions, particularly in relation to the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), which guide global transport and trade. There are a number of ways that the current approach to wildlife welfare could be improved, and we propose ways forward in this regard

Effect of two behavioural 'nudging' interventions on management decisions for low back pain: A randomised vignette-based study in general practitioners

Objective €Nudges' are subtle cognitive cues thought to influence behaviour. We investigated whether embedding nudges in a general practitioner (GP) clinical decision support display can reduce low-value management decisions. Methods Australian GPs completed four clinical vignettes of patients with low back pain. Participants chose from three guideline-concordant and three guideline-discordant (low-value) management options for each vignette, on a computer screen. A 2×2 factorial design randomised participants to two possible nudge interventions: €partition display' nudge (low-value options presented horizontally, high-value options listed vertically) or €default option' nudge (high-value options presented as the default, low-value options presented only after clicking for more). The primary outcome was the proportion of scenarios where practitioners chose at least one of the low-value care options. Results 120 GPs (72% male, 28% female) completed the trial (n=480 vignettes). Participants using a conventional menu display without nudges chose at least one low-value care option in 42% of scenarios. Participants exposed to the default option nudge were 44% less likely to choose at least one low-value care option (OR 0.56, 95%CI 0.37 to 0.85; p=0.006) compared with those not exposed. The partition display nudge had no effect on choice of low-value care (OR 1.08, 95%CI 0.72 to 1.64; p=0.7). There was no interaction between the nudges (OR 0.94, 95% CI 0.41 to 2.15; p=0.89). Interpretation A default option nudge reduced the odds of choosing low-value options for low back pain in clinical vignettes. Embedding high value options as defaults in clinical decision support tools could improve quality of care. More research is needed into how nudges impact clinical decision-making in different contexts

Evaluating the cost-effectiveness of existing needle and syringe programmes in preventing hepatitis C transmission in people who inject drugs

AIM: To evaluate the cost-effectiveness of needle and syringe programmes (NSPs) compared with no NSPs on hepatitis C virus (HCV) transmission in the United Kingdom. DESIGN: Cost-effectiveness analysis from a National Health Service (NHS)/health-provider perspective, utilizing a dynamic transmission model of HCV infection and disease progression, calibrated using city-specific surveillance and survey data, and primary data collection on NSP costs. The effectiveness of NSPs preventing HCV acquisition was based on empirical evidence. SETTING AND PARTICIPANTS: UK settings with different chronic HCV prevalence among people who inject drugs (PWID): Dundee (26%), Walsall (18%) and Bristol (45%) INTERVENTIONS: Current NSP provision is compared with a counterfactual scenario where NSPs are removed for 10 years and then returned to existing levels with effects collected for 40 years. MEASUREMENTS: HCV infections and cost per quality-adjusted life year (QALY) gained through NSPs over 50 years. FINDINGS: Compared with a willingness-to-pay threshold of £20 000 per QALY gained, NSPs were highly cost-effective over a time-horizon of 50 years and decreased the number of HCV incident infections. The mean incremental cost-effectiveness ratio was cost-saving in Dundee and Bristol, and £596 per QALY gained in Walsall, with 78, 46 and 40% of simulations being cost-saving in each city, respectively, with differences driven by coverage of NSP and HCV prevalence (lowest in Walsall). More than 90% of simulations were cost-effective at the willingness-to-pay threshold. Results were robust to sensitivity analyses, including varying the time-horizon, HCV treatment cost and numbers of HCV treatments per year. CONCLUSIONS: Needle and syringe programmes are a highly effective low-cost intervention to reduce hepatitis C virus transmission, and in some settings they are cost-saving. Needle and syringe programmes are likely to remain cost-effective irrespective of changes in hepatitis C virus treatment cost and scale-up