BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :Widespread interest in global health issues is a common characteristic of students and faculty in schools of public health and schools of medicine. Building on strong university-based and community-based programs in global health, the University of Washington has created a unique Department of Global Health that is housed jointly in its School of Public Health and Community Medicine and its School of Medicine. The creation of this department has generated significant enthusiasm throughout the university and the Seattle community as a new paradigm for addressing global health education, research, and service. Placing the new Department of Global Health in two university schools and finding the appropriate niche for the department among the university's many global health initiatives presented challenges, as well as opportunities. This article describes the goals of the department, the process by which it was created, and what it expects to accomplish.

背景与目标： : 对全球卫生问题的广泛关注是公共卫生学院和医学院的学生和教职员工的共同特征。华盛顿大学以强大的基于大学和社区的全球卫生计划为基础，创建了一个独特的全球卫生部门，该部门位于其公共卫生和社区医学学院及其医学院中。这个部门的创建在整个大学和西雅图社区产生了极大的热情，成为解决全球健康教育，研究和服务的新范式。将新的全球卫生部门安置在两所大学学校中，并在大学的许多全球卫生计划中找到适合该部门的利基市场，带来了挑战和机遇。本文介绍了该部门的目标，创建该部门的过程以及预期实现的目标。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :The recognition that human papillomavirus (HPV) infection is the central, necessary cause of cervical cancer paved the way to new fronts of prevention via improved screening methods and HPV vaccination. Much has been learned in all fronts, from the molecular basis of our understanding of how HPV causes disease to the health economics of preventive strategies at the individual and population levels. Progress in other areas of cancer control has yet to show the same multi- and trans-disciplinary gains seen in research on HPV-associated malignancies, which is one of the unequivocal success stories in disease prevention. Yet, as an embarrassment of riches, much more research is needed to fill the gaps in knowledge that remain before we are able to reap the benefits from the knowledge translation from all fronts. Public health research on setting-specific implementation of HPV-based preventive strategies and more concerted advocacy to counter barriers facing the adoption of these strategies are likely to yield major dividends in reducing the burden of HPV-associated diseases. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.

背景与目标： : 认识到人乳头瘤病毒 (HPV) 感染是宫颈癌的主要必要原因，通过改进筛查方法和HPV疫苗接种，为预防的新领域铺平了道路。从我们对HPV如何引起疾病的理解的分子基础到个人和人群水平的预防策略的健康经济学，在各个方面都学到了很多东西。癌症控制的其他领域的进展尚未显示出与HPV相关的恶性肿瘤研究中相同的多学科和跨学科收益，这是疾病预防中明确的成功案例之一。然而，作为财富的尴尬，需要更多的研究来填补知识的空白，这些空白在我们能够从各个方面获得知识翻译的好处之前仍然存在。针对特定环境实施基于HPV的预防策略的公共卫生研究以及采取这些策略所面临的障碍的更协调一致的倡导，可能会在减轻HPV相关疾病的负担方面产生重大好处。本文是2012年《HPV感染及相关疾病的综合控制》疫苗第30卷第5期补充的部分内容。

BACKGROUND & AIMS: :Discussions of drug policy tend not to consider whether the stated goals of policies are an accurate statement of what they are meant to do and also may not consider the fact that what benefits some people may harm others. We explore these issues and present an agenda for research in this area that, while not eliminating these difficulties, both illuminates them and can help guide actors toward more effective action.

背景与目标： : 关于毒品政策的讨论往往不会考虑政策的既定目标是否是对其意图的准确陈述，也可能不会考虑这样一个事实，即某些人的利益可能会损害其他人。我们探讨了这些问题，并提出了该领域的研究议程，尽管没有消除这些困难，但两者都阐明了这些困难，并可以帮助指导行为者采取更有效的行动。

BACKGROUND & AIMS: BACKGROUND:Road traffic injuries contribute substantially to the disease burden in India. This paper describes the road safety issues discussed by members of the Indian Parliament, and highlights the gaps that need to be addressed to make road safety visible as a public health problem to policy-makers in India. METHODS:All questions asked to and information provided by the Ministry of Road Transport and Highways, and questions relating to accident asked to the Ministry of Health and Family Welfare of the Government of India were reviewed for the two Houses of the Indian Parliament for the years 2002 to 2004. RESULTS:Of the 1529 questions asked to the Ministry of Road Transport and Highways, only 140 (9.1%) were related to road safety, whereas 1076 (70.5%), 181 (11.8%), 51 (3.3%) and 81 (5.3%) were related to other aspects of the national highways, state roads, vehicles and other issues, respectively. Data on the magnitude of road crashes dealt only with the number of crashes and fatalities and not with the age, sex and type of road users affected by road traffic injuries. The parliamentarians were informed that human error was the main cause of road crashes in India; however, the robustness of this information is questionable. Strategies to prevent road crashes focused mainly on training of drivers with little attention to other factors that cause road crashes. The discussion on legislations also focused on drivers, ignoring other road users. Ten of the 4741 questions (0.2%) asked to Ministry of Health and Family Welfare were related to accident, the majority of which were about the setting up of trauma care services. CONCLUSION:An appropriate policy and intervention response by policy-makers is not possible with data that are presented in a manner that do not highlight the true nature of the problem, and are neither comprehensive nor robust. Majority of the proposed road safety interventions by the Ministry of Road Transport and Highways are based on the traditional view of human error as a major cause of road crashes highlighting the lack of a scientific public health approach towards prevention of road crashes. It would be useful to build the technical capacity of the Ministry of Road Transport and Highways in road safety to use the available data more effectively, and to facilitate generation of further relevant data about the magnitude, underlying causes and impact of road traffic injuries, for policy-makers to better understand the critical issues for planning effective road safety policies and interventions to reduce the high burden of mortality and morbidity due to road crashes in India.

背景与目标：

BACKGROUND & AIMS: STUDY QUESTION:What was the impact on access to assisted reproductive technology (ART) treatment by different socioeconomic status (SES) groups after the introduction of a policy that increased patient out-of-pocket costs? SUMMARY ANSWER:After the introduction of a policy that increased out-of-pocket costs in Australia, all SES groups experienced a similar percentage reduction in fresh ART cycles per 1000 women of reproductive age. Higher SES groups experienced a progressively greater reduction in absolute numbers of fresh ART cycles due to existing higher levels of utilization. WHAT IS KNOWN ALREADY:Australia has supportive public funding arrangements for ARTs. Policies that substantially increase out-of-pocket costs for ART treatment create financial barriers to access and an overall reduction in utilization. Data from the USA suggests that disparities exist in access to ART treatment based on ethnicity, education level and income. STUDY DESIGN, SIZE, DURATION:Time series analysis of utilization of ART, intrauterine insemination (IUI) and clomiphene citrate by women from varying SES groups before and after the introduction of a change in the level of public funding for ART. PARTICIPANTS/MATERIALS, SETTING, METHODS:Women undertaking fertility treatment in Australia between 2007 and 2010. MAIN RESULTS AND THE ROLE OF CHANCE:Women from higher SES quintiles use more ART treatment than those in lower SES quintiles, which likely reflects a greater ability to pay for treatment and a greater need for ART treatment as indicated by the trend to later childbearing. In 2009, 10.13 and 5.17 fresh ART cycles per 1000 women of reproductive age were performed in women in the highest and lowest SES quintiles respectively. In the 12 months after the introduction of a policy that increased out-of-pocket costs from ∼$1500 Australian dollars (€1000) to ∼$2500 (€1670) for a fresh IVF cycle, there was a 21-25% reduction in fresh ART cycles across all SES quintiles. The absolute reduction in fresh ART cycles in the highest SES quintile was double that in the lowest SES quintile. LIMITATIONS, REASONS FOR CAUTION:In this study, SES was based on the average relative socioeconomic advantage and disadvantage of small geographic areas, and therefore may not reflect the SES of an individual. Additionally, the policy impact was limited to the 12 months following its introduction, and may not reflect longer term trends in ART treatment. WIDER IMPLICATIONS OF THE FINDINGS:While financial barriers are an important obstacle to equitable access to ARTs, socioeconomic differences in utilization are likely to persist in countries with supportive public funding, due in part to differences in childbearing patterns and treatment seeking behaviour. Policy makers should be informed of the impact that changes in the level of cost subsidization have on access to ART treatment by different socioeconomic groups. STUDY FUNDING/COMPETING INTEREST(S):G.M.C. receives grant support to her institution from the Australian Government, Australian Research Council (ARC) Linkage Grant No LP1002165; ARC Linkage Grant Partner Organisations are IVFAustralia, Melbourne IVF and Queensland Fertility Group. V.P.H. is employed as an Economics Research Associate on the same grant. P.J.I. is Medical Director of the IVF Clinic, IVFAustralia and has a financial interest in the parent group, Virtus. TRIAL REGISTRATION NUMBER:N/A.

背景与目标：

BACKGROUND & AIMS: :Recognizing that robust information on health systems in other countries can provide valuable lessons for the English National Health Service, the Department of Health commissioned an academic team to provide an 'On-call Facility for International Healthcare Comparisons' in 2005. This paper describes the work of this novel approach to informing policy and reviews the experience of the first two years. It illustrates the well-documented challenges of comparative analysis of health systems. One important issue is understanding the health system context so as to interpret phenomena and draw appropriate policy conclusions. Other challenges include the potential tension between academic interest and rigour, and the need for timely analysis to inform the Department of Health's rapidly changing policy agenda. The diversity and nature of topics covered, as well as the rapid turn-around time have meant that the Facility has had to balance rigour and timeliness carefully to ensure the value and relevance of reports. A strong research base linked with an international network of country experts promotes the provision of high quality analyses at relatively low costs. However, such an arrangement can only be sustained if it provides scope for additional primary research. A formal evaluation of the influence on health care policy-making in England is not yet available. Such knowledge will be of crucial importance for the development of similar resources elsewhere.

背景与目标： : 认识到其他国家卫生系统的可靠信息可以为英国国家卫生服务局提供宝贵的经验教训，卫生部委托一个学术团队为国际医疗保健比较提供 “随叫随到的设施” 2005年。本文介绍了这种新颖的政策通报方法的工作，并回顾了前两年的经验。它说明了卫生系统比较分析的有据可查的挑战。一个重要的问题是了解卫生系统的背景，以便解释现象并得出适当的政策结论。其他挑战包括学术兴趣和严谨之间的潜在紧张关系，以及需要及时分析以告知卫生部迅速变化的政策议程。所涵盖主题的多样性和性质以及快速的周转时间意味着该设施必须仔细平衡严谨性和及时性，以确保报告的价值和相关性。与国际国家专家网络相联系的强大研究基础促进以相对较低的成本提供高质量的分析。然而，这种安排只有在为额外的初级研究提供空间的情况下才能持续下去。尚未对英格兰对医疗保健政策制定的影响进行正式评估。这些知识对于在其他地方开发类似资源至关重要。

BACKGROUND & AIMS: :In a prospective cohort study of Finnish public sector employees, the authors examined the association between workplace social capital and depression. Data were obtained from 33,577 employees, who had no recent history of antidepressant treatment and who reported no history of physician-diagnosed depression at baseline in 2000-2002. Their risk of depression was measured with two indicators: recorded purchases of antidepressants until December 31, 2005, and self-reports of new-onset depression diagnosed by a physician in the follow-up survey in 2004-2005. Multilevel logistic regression analysis was used to explore whether self-reported and aggregate-level workplace social capital predicted indicators of depression at follow-up. The odds for antidepressant treatment and physician-diagnosed depression were 20-50% higher for employees with low self-reported social capital than for those reporting high social capital. These associations were not accounted for by sex, age, marital status, socioeconomic position, place of work, smoking, alcohol use, physical activity, and body mass index. The association between social capital and self-reported depression attenuated but remained significant after further adjustment for baseline psychological distress (a proxy for undiagnosed mental health problems). Aggregate-level social capital was not associated with subsequent depression.

背景与目标： : 在一项对芬兰公共部门雇员的前瞻性队列研究中，作者研究了工作场所社会资本与抑郁症之间的关联。数据来自33,577名员工，他们最近没有抗抑郁药治疗史，并且在2000-2002年的基线时没有医生诊断的抑郁症病史。通过两个指标来衡量他们的抑郁症风险: 记录到2005年12月31日之前的抗抑郁药购买量，以及2004-2005年医生在随访调查中诊断出的新发抑郁症的自我报告。使用多水平logistic回归分析来探讨自我报告和综合水平的工作场所社会资本是否可以预测随访时的抑郁指标。自我报告社会资本低的员工的抗抑郁治疗和医生诊断的抑郁症的几率比报告社会资本高的员工高20-50%。这些关联没有按性别，年龄，婚姻状况，社会经济地位，工作地点，吸烟，饮酒，体育锻炼和体重指数来解释。社会资本与自我报告的抑郁症之间的关联减弱，但在进一步调整基线心理困扰 (未诊断的精神卫生问题的代表) 后仍然显着。总水平的社会资本与随后的萧条无关。

BACKGROUND & AIMS: OBJECTIVES:To describe the US public health nutrition workforce and its future social, biological and fiscal challenges. DESIGN:Literature review primarily for the four workforce surveys conducted since 1985 by the Association of State and Territorial Public Health Nutrition Directors. SETTING:The United States. SUBJECTS:Nutrition personnel working in governmental health agencies. The 1985 and 1987 subjects were personnel in full-time budgeted positions employed in governmental health agencies providing predominantly population-based services. In 1994 and 1999 subjects were both full-time and part-time, employed in or funded by governmental health agencies, and provided both direct-care and population-based services. RESULTS:The workforce primarily focuses on direct-care services for pregnant and breast-feeding women, infants and children. The US Department of Agriculture funds 81.7 % of full-time equivalent positions, primarily through the WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children). Of those personnel working in WIC, 45 % have at least 10 years of experience compared to over 65 % of the non-WIC workforce. Continuing education needs of the WIC and non-WIC workforces differ. The workforce is increasingly more racially/ethnically diverse and with 18.2 % speaking Spanish as a second language. CONCLUSIONS:The future workforce will need to focus on increasing its diversity and cultural competence, and likely will need to address retirement within leadership positions. Little is known about the workforce's capacity to address the needs of the elderly, emergency preparedness and behavioural interventions. Fiscal challenges will require evidence-based practice demonstrating both costs and impact. Little is known about the broader public health nutrition workforce beyond governmental health agencies.

背景与目标：

BACKGROUND & AIMS: :In 1998 the Society for Academic Emergency Medicine's (SAEM's) Board of Directors asked the SAEM Public Health and Education Task Force to develop recommendations for prevention, screening, and counseling activities to be conducted in emergency departments (EDs). The Task Force's work was divided into two phases: 1) a discussion of the rationale for preventive services in the ED, along with generation of a preliminary list of prevention activities that could be studied for ED implementation; and 2) a formal evidence-based review of topics chosen from the preliminary list, along with recommendations for ED implementation and further study. This paper represents Phase I of the project. Phase II, the formal evidence-based review and recommendations, is published separately in this issue.

背景与目标： : 1998年，学术急诊医学协会 (SAEM's) 董事会要求SAEM公共卫生和教育工作组为在急诊科 (EDs) 进行的预防，筛查和咨询活动制定建议。专责小组的工作分为两个阶段: 1) 讨论在ED中提供预防服务的理由，并生成可研究用于ED实施的预防活动的初步清单; 2) 对从初步清单中选择的主题进行正式的循证审查，以及对ED实施和进一步研究的建议。本文代表了该项目的第一阶段。第二阶段，正式的循证审查和建议，在本期单独发表。

BACKGROUND & AIMS: :The aim of this study was to assess the prevalence of dental caries in the primary dentition and associated variables in low socioeconomic preschool children enrolled in public nursery schools in Juiz de Fora, Minas Gerais, Brazil. Four public institutions were selected by geographic criteria (two in the central region and two in the peripheral region). The study population comprised 338 children (181 boys; 157 girls) aged 2-6 years old. Dental caries was recorded using the decayed, missing, and filled teeth (dmf-t) index. Among the examined children, 50.6% were caries-free. The mean dmf-t index was 2.03. It was higher in the peripheral nursery schools (p<0.01). A trend towards a difference between sexes (p = 0.06) was observed. Logistic regression analysis selected a previous child's visit to dentist (p<0.001), geographic location of the public nursery school (p<0.01), and age (p<0.01) as predictive variables for the dmf-t index. The study showed the need for an oral health program for this population, including both curative and preventive measures in order to achieve the WHO/FDI goals for the year 2000, namely 50% of children free of caries at age 5-6 years.

背景与目标： : 这项研究的目的是评估在巴西米纳斯吉拉斯州Juiz de Fora的公立托儿所就读的低社会经济学龄前儿童的主要牙列中龋齿的患病率和相关变量。根据地理标准选择了四个公共机构 (两个在中部地区，两个在外围地区)。研究人群包括2-6岁的338名儿童 (181名男孩; 157名女孩)。使用腐烂，缺失和填充的牙齿 (dmf-t) 指数记录龋齿。在接受检查的儿童中，有50.6% 人没有龋齿。平均dmf-t指数为2.03。在外围托儿所中较高 (p<0.01)。观察到性别差异的趋势 (p = 0.06)。Logistic回归分析选择了以前的儿童去看牙医 (p<0.001)，公立托儿所的地理位置 (p<0.01) 和年龄 (p<0.01) 作为dmf-t指数的预测变量。该研究表明，需要为这一人群制定口腔保健方案，包括治疗和预防措施，以实现世卫组织/外国直接投资2000年的目标，即50% 5-6岁无龋齿儿童。

BACKGROUND & AIMS: :South Africa has long recognized partnerships between the public and private sectors as a policy objective in health, but experience is still limited and poorly documented. The objectives of this article are to understand the factors that increase the likelihood of success of public-private interactions in South Africa, and identify and discuss opportunities for them to be scaled up. There is a strong legislative framework and a number of guidelines and tools that have been developed by the Treasury for managing partnerships. The review of literature confirmed the need for the state to have effective regulations in order to oversee quality and standards and to provide stewardship and oversight. The public sector requires sufficient capacity not only to manage relationships with the private sector but also to enable innovation and experimentation. Evaluation is an integral part of all interactions not only to learn from successes but also to identify any perverse incentives that may lead to unintended consequences. Four case studies show that the private for-profit sector is already engaged in a number of projects that are closely aligned to current health system reform priorities. Factors that increase the likelihood of interactions being successful include: increasing the government's capacity to manage public-private relationships; choosing public-private interactions that are strategically important to national goals; building a knowledge base on what works, where and why; moving from pilots to large scale initiatives; harnessing the contracting expertise in private providers; and encouraging innovation and learning.

背景与目标： : 南非长期以来一直承认公共部门和私营部门之间的伙伴关系是卫生方面的政策目标，但经验仍然有限，而且文献记载很少。本文的目的是了解增加南非公私互动成功可能性的因素，并确定和讨论扩大它们的机会。财政部为管理伙伴关系制定了强有力的立法框架和许多准则和工具。对文献的审查证实，国家需要制定有效的法规，以监督质量和标准，并提供管理和监督。公共部门不仅需要足够的能力来管理与私营部门的关系，而且还需要创新和实验。评估是所有互动的组成部分，不仅要从成功中学习，而且要确定可能导致意外后果的任何不正当激励措施。四个案例研究表明，私营营利部门已经参与了许多与当前卫生系统改革优先事项密切相关的项目。增加互动成功可能性的因素包括: 提高政府管理公私关系的能力; 选择对国家目标具有战略重要性的公私互动; 建立有效的知识基础，在何处以及为什么; 从试点转向大规模计划; 利用私人供应商的合同专业知识; 鼓励创新和学习。

BACKGROUND & AIMS: :Tungiasis (sand flea disease) is an ectoparasitic skin disease caused by the female sand flea/jigger flea (Tunga penetrans). As poverty is the major driving force of the disease, it can be called as a poverty-associated plague. It is one of the emerging neglected diseases in Latin America, Caribbean, sub-Saharan Africa, and India. The aim of the present scrutiny was to assess the public health impact of tungiasis, associated risk factors, and emerging opportunities to prevent and control tungiasis. Searches of PubMed, Google Scholar, and online search engines (Google, AOL, and Yahoo) using keywords "parasitic skin disease," "tungiasis," "sand flea," " tungiasis-associated risk factors," "tungiasis prevention and control," and their synonyms were used as a source of references. Searches were made without time limitations. Of 167 potential articles identified by these criteria, 51 appropriate were selected for review. Tungiasis is widespread in the resource-constrained settings of low-income economies. In the tropics, it is highly prevalent among the impoverished populations, but the associated risk factors are often poorly identified and remain uncontrolled. Though it is a self-limiting disease with considerable morbidity, the parasite may cause subsequent secondary morbidity through life-threatening complications and infections like cellulitis, tetanus, and death. However, the direct and indirect sociocultural, economic, and health impact of tungiasis is often undervalued and misunderstood. A systematic assessment on disease burden is still dearth and deficient. Over the decades, tungiasis has been largely neglected by the scientific community, policy makers, and healthcare stakeholders. In the endemic regions, even tungiasis is not listed for the disease control priorities in the regional, national, and international agenda. The majority of the epidermal parasitic skin diseases particularly tungiasis needs a sustainable global scientific research and control policy. This urges intensive efforts to develop a road map that delivers a clear vision towards zero new infection by designing low-cost prevention and control strategies. Besides, there is an urgency to develop culturally appropriate communication techniques and workable collaboration on a global scale by bringing all the stakeholders of endemic countries.

背景与目标： : Tungiasis (沙蚤病) 是由雌性沙蚤/跳蚤 (Tunga penetrans) 引起的一种外部寄生虫性皮肤病。由于贫困是该疾病的主要驱动力，因此可以将其称为与贫困相关的瘟疫。它是拉丁美洲，加勒比海地区，撒哈拉以南非洲和印度新兴的被忽视的疾病之一。本次审查的目的是评估外膜病对公共卫生的影响，相关的危险因素以及预防和控制外膜病的新兴机会。搜索PubMed，Google Scholar和在线搜索引擎 (Google，AOL和Yahoo)，使用关键字 “寄生性皮肤病”，“tungiasis”，“沙蚤”，“tungiasis相关危险因素”，“tungiasis预防和控制，” 和它们的同义词被用作参考文献的来源。搜索没有时间限制。在这些标准确定的167篇潜在文章中，选择了51篇合适的文章进行审查。在低收入经济体资源受限的环境中，突尼斯病很普遍。在热带地区，它在贫困人口中非常普遍，但相关的风险因素往往无法识别，并且仍然不受控制。尽管它是一种具有相当高发病率的自限性疾病，但该寄生虫可能会通过威胁生命的并发症和感染 (如蜂窝织炎，破伤风和死亡) 引起继发疾病。但是，tungiasis对社会文化，经济和健康的直接和间接影响常常被低估和误解。对疾病负担的系统评估仍然缺乏和不足。几十年来，tungiasis在很大程度上被科学界，政策制定者和医疗保健利益相关者所忽视。在流行地区，甚至在区域，国家和国际议程中也没有将tungiasis列为疾病控制重点。大多数表皮寄生性皮肤病，尤其是tungiasis，需要可持续的全球科学研究和控制政策。这敦促加紧努力，制定路线图，通过设计低成本的预防和控制策略，实现零新感染的清晰愿景。此外，迫切需要通过吸引流行国家的所有利益攸关方，在全球范围内发展文化上适当的交流技术和可行的合作。

BACKGROUND & AIMS: :Cooperation declines in repeated public good games because individuals behave as conditional cooperators. This is because individuals imitate the social behaviour of successful individuals when their payoff information is available. However, in human societies, individuals cooperate in many situations involving social dilemmas. We hypothesize that humans are sensitive to both success (payoffs) and how that success was obtained, by cheating (not socially sanctioned) or good behaviour (socially sanctioned and adds to prestige or reputation), when information is available about payoffs and prestige. We propose and model a repeated public good game with heterogeneous conditional cooperators where an agent's donation in a public goods game depends on comparing the number of donations in the population in the previous round and with the agent's arbitrary chosen conditional cooperative criterion. Such individuals imitate the social behaviour of role models based on their payoffs and prestige. The dependence is modelled by two population-level parameters: affinity towards payoff and affinity towards prestige. These affinities influence the degree to which agents value the payoff and prestige of role models. Agents update their conditional strategies by considering both parameters. The simulations in this study show that high levels of cooperation are established in a population consisting of heterogeneous conditional cooperators for a certain range of affinity parameters in repeated public good games. The results show that social value (prestige) is important in establishing cooperation.

背景与目标： : 合作在重复的公益游戏中下降，因为个人表现为有条件的合作者。这是因为当个人的收益信息可用时，个人会模仿成功个人的社会行为。然而，在人类社会中，个人在许多涉及社会困境的情况下进行合作。我们假设人类对成功 (收益) 和成功是如何获得的敏感，通过欺骗 (不是社会认可的) 或良好的行为 (社会认可的，并增加了声望或声誉)，当有关收益和声望的信息可用时。我们提出并建立了具有异质条件合作者的重复公共物品博弈模型，其中公共物品博弈中代理人的捐赠取决于比较上一轮人口中的捐赠数量以及代理人任意选择的条件合作标准。这些人根据他们的回报和声望来模仿榜样的社会行为。依赖关系由两个人口水平的参数建模: 对回报的亲和力和对声望的亲和力。这些亲和力会影响代理人对榜样的回报和声望的重视程度。代理通过考虑两个参数来更新其条件策略。这项研究中的模拟表明，在重复的公益游戏中，对于一定范围的亲和力参数，在由异质条件合作者组成的人群中建立了高水平的合作。结果表明，社会价值 (声望) 在建立合作中很重要。