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Objectives: Utilizing policy innovation and diffusion theory, this study aims to explain why city governments adopt housing adaptation policies that primarily benefit older people based on the case of China., Methods: The data are drawn from an event history data set of a housing adaptation policy for older people collected from 283 Chinese cities from 2010 to 2018. Piecewise constant exponential models are utilized., Results: The results indicate that cities facing greater internal pressure and a higher political status are more likely to adopt a housing adaptation policy for older people. Policy adoption by neighboring cities could further facilitate this process., Discussion: Policy innovation and diffusion theory provide a useful framework for this study. That is, the Chinese city government's adoption of housing adaptation policy for older adults is initially driven by local needs and then accelerated by interactions among neighboring governments., (© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The COVID-19 pandemic has posed novel risks related to the indoor mixing of individuals from different households and challenged policymakers to adequately regulate this behaviour. While in many cases household visits are necessary for the purpose of social care, they have been linked to broadening community transmission of the virus. In this study we propose a novel, privacy-preserving framework for the measurement of household visitation at national and regional scales, making use of passively collected mobility data. We implement this approach in England from January 2020 to May 2021. The measures expose significant spatial and temporal variation in household visitation patterns, impacted by both national and regional lockdown policies, and the rollout of the vaccination programme. The findings point to complex social processes unfolding differently over space and time, likely informed by variations in policy adherence, vaccine relaxation, and regional interventions., (© 2021. The Author(s).)

Since the 1990s, universities have faced a push toward output commercialization that has been seen as a potential threat to the public science model. Much less attention has been given to the enduring nature of internal organizational features in academia and how they shape the pursuit of traditional scholarly activities. This article exploits four waves of representative, random-sample survey evidence from agricultural and life science faculty at the 52 major U.S. land-grant universities, spanning 1989-2015, to examine faculty attitudes/preferences, tenure and promotion criteria, output, and funding sources. Our findings demonstrate that faculty attitudes toward scientific research have remained remarkably stable over twenty-five years in strongly favoring intrinsic and public science goals over commercial or extrinsic goals. We also demonstrate the faculty's positive attitudes toward science, an increased pressure to publish in top journals and secure increasingly competitive grants, as well as declining time for science. These trends suggest a reconsideration of university commercialization strategies and a recommitment of universities and their state and federal funders toward fostering public agricultural and life science research., Competing Interests: The authors have declared that no competing interests exist.

The United Nations' (UN) Sustainable Development Goals (SDGs) are heterogeneous and interdependent, comprising 169 targets and 231 indicators of sustainable development in such diverse areas as health, the environment, and human rights. Existing efforts to map relationships among SDGs are either theoretical investigations of sustainability concepts, or empirical analyses of development indicators and policy simulations. We present an alternative approach, which describes and quantifies the complex network of SDG interdependencies by applying computational methods to policy and scientific documents. Methods of Natural Language Processing are used to measure overlaps in international policy discourse around SDGs, as represented by the corpus of all existing UN progress reports about each goal (N = 85 reports). We then examine if SDG interdependencies emerging from UN discourse are reflected in patterns of integration and collaboration in SDG-related science, by analyzing data on all scientific articles addressing relevant SDGs in the past two decades (N = 779,901 articles). Results identify a strong discursive divide between environmental goals and all other SDGs, and unexpected interdependencies between SDGs in different areas. While UN discourse partially aligns with integration patterns in SDG-related science, important differences are also observed between priorities emerging in UN and global scientific discourse. We discuss implications and insights for scientific research and policy on sustainable development after COVID-19., (© 2021. The Author(s).)

With recurring waves of the Covid-19 pandemic, a dilemma facing public health leadership is whether to provide public advice that is medically optimal (e.g., most protective against infection if followed), but unlikely to be adhered to, or advice that is less protective but is more likely to be followed. To provide insight about this dilemma, we examined and quantified public perceptions about the tradeoff between (a) the stand-alone value of health behavior advice, and (b) the advice's adherence likelihood. In a series of studies about preference for public health leadership advice, we asked 1061 participants to choose between (5) strict advice that is medically optimal if adhered to but which is less likely to be broadly followed, and (2) relaxed advice, which is less medically effective but more likely to gain adherence-given varying infection expectancies. Participants' preference was consistent with risk aversion. Offering an informed choice alternative that shifts volition to advice recipients only strengthened risk aversion, but also demonstrated that informed choice was preferred as much or more than the risk-averse strict advice., (© 2021. The Author(s).)

Background: Despite the development and enforcement of preventive guidelines by governments, COVID-19 continues to spread across nations, causing unprecedented economic losses and mortality. Public places remain hotspots for COVID-19 transmission due to large numbers of people present; however preventive measures are poorly enforced. Supermarkets are among the high-risk establishments due to the high interactions involved, which makes compliance with the COVID-19 preventive guidelines of paramount importance. However, until now, there has been limited evidence on compliance with the set COVID-19 prevention guidelines. Therefore, this study aimed to measure compliance with the COVID-19 prevention guidelines among supermarkets in Kampala Capital City and Mukono Municipality Uganda., Methods: A cross-sectional study was conducted among selected supermarkets in Kampala Capital City and Mukono Municipality in September 2020. A total of 229 supermarkets (195 in Kampala City and 34 in Mukono Municipality) were randomly selected for the study. Data were collected through structured observations on the status of compliance with COVID-19 prevention guidelines, and entered using the KoboCollect software, which was preinstalled on mobile devices (smart phones and tablets). Descriptive statistics were generated to measure compliance to the set COVID-19 Ministry of Health prevention guidelines using Stata 14 software., Results: Only 16.6% (38/229) of the supermarkets complied with the COVID-19 prevention and control guidelines. In line with the specific measures, almost all supermarkets 95.2% (218/229) had hand washing facilities placed at strategic points such as the entrance, and 59.8% (137/229) of the supermarkets surveyed regularly disinfected commonly touched surfaces. Only 40.6% and 30.6% of the supermarkets enforced mandatory hand washing and use of face masks respectively for all customers accessing the premises. Slightly more than half, 52.4% (120/229) of the supermarkets had someone or a team in charge of enforcing compliance to COVID-19 measures and more than half, 55.5% (127/229) of the supermarkets had not provided their staff with job-specific training/mentorship on infection prevention and control for COVID-19. Less than a third, 26.2% (60/229) of the supermarkets had an infrared temperature gun for screening every customer, and only 5.7% (13/229) of the supermarkets captured details of clients accessing the supermarket as a measure to ease follow-up., Conclusion: This study revealed low compliance with COVID-19 guidelines, which required mandatory preventive measures such as face masking, regular disinfection, social distancing, and hand hygiene. This study suggests the need for health authorities to strengthen enforcement of these guidelines, and to sensitise the supermarket managers on COVID-19 in order to increase the uptake of the different measures., Competing Interests: The authors declare that they have no competing interests.

Social scientists identify two core functions of modern welfare states as redistribution across (a) socio-economic status groups (Robin Hood) and (b) 'the lifecycle' (the piggy bank). But what is the relative importance of these functions? The answer has been elusive, as the piggy bank is metaphorical. The intra-personal time-travel of resources it implies is based on non-quid-pro-quo transfers. In practice, 'lifecycle redistribution' must operate through inter-age-group resource reallocation in cross-section. Since at any time different birth cohorts live together, 'resource-productive' working-aged people are taxed to finance consumption of 'resource-dependent' younger and older people. In a novel decomposition analysis, we study the joint distribution of socio-economic status, age, and respectively (a) all cash and in-kind transfers ('benefits'), (b) financing contributions ('taxes'), and (c) resulting 'net benefits,' on a sample of over 400,000 Europeans from 22 EU countries. European welfare states, often maligned as ineffective Robin Hood vehicles riddled with Matthew effects, are better characterized as inter-age redistribution machines performing a more important second task rather well: lifecycle consumption smoothing. Social policies serve multiple goals in Europe, but empirically they are neither primarily nor solely responsible for poverty relief and inequality reduction., Competing Interests: The authors have declared that no competing interests exist.

In this work, we propose a quantitative model for the 2019 Chilean protests. We utilize public data for the consumer price index, the gross domestic product, and the employee and per capita income distributions as inputs for a nonlinear diffusion-reaction equation, the solutions to which provide an in-depth analysis of the population dynamics. Specifically, the per capita income distribution stands out as a solution to the extended Fisher-Kolmogorov equation. According to our results, the concavity of employee income distribution is a decisive input parameter and, in contrast to the distributions typically observed for Chile and other countries in Latin America, should ideally be non-negative. Based on the results of our model, we advocate for the implementation of social policies designed to stimulate social mobility by broadening the distribution of higher salaries., Competing Interests: The authors have declared that no competing interests exist.

The COVID-19 pandemic (SARS-CoV-2) has revealed the need for proactive protocols to react and act, imposing preventive and restrictive countermeasures on time in any society. The extent to which confirmed cases can predict the morbidity and mortality in a society remains an unresolved issue. The research objective is therefore to test a generic model's predictability through time, based on percentage of confirmed cases on hospitalized patients, ICU patients and deceased. This study reports the explanatory and predictive ability of COVID-19-related healthcare data, such as whether there is a spread of a contagious and virulent virus in a society, and if so, whether the morbidity and mortality can be estimated in advance in the population. The model estimations stress the implementation of a pandemic strategy containing a proactive protocol entailing what, when, where, who and how countermeasures should be in place when a virulent virus (e.g. SARS-CoV-1, SARS-CoV-2 and MERS) or pandemic strikes next time. Several lessons for the future can be learnt from the reported model estimations. One lesson is that COVID-19-related morbidity and mortality in a population is indeed predictable. Another lesson is to have a proactive protocol of countermeasures in place., (© 2021. The Author(s).)

Many of the world's most pressing issues, such as the emergence of zoonotic diseases, can only be addressed through interdisciplinary research. However, the findings of interdisciplinary research are susceptible to miscommunication among both professional and non-professional audiences due to differences in training, language, experience, and understanding. Such miscommunication contributes to the misunderstanding of key concepts or processes and hinders the development of effective research agendas and public policy. These misunderstandings can also provoke unnecessary fear in the public and have devastating effects for wildlife conservation. For example, inaccurate communication and subsequent misunderstanding of the potential associations between certain bats and zoonoses has led to persecution of diverse bats worldwide and even government calls to cull them. Here, we identify four types of miscommunication driven by the use of terminology regarding bats and the emergence of zoonotic diseases that we have categorized based on their root causes: (1) incorrect or overly broad use of terms; (2) terms that have unstable usage within a discipline, or different usages among disciplines; (3) terms that are used correctly but spark incorrect inferences about biological processes or significance in the audience; (4) incorrect inference drawn from the evidence presented. We illustrate each type of miscommunication with commonly misused or misinterpreted terms, providing a definition, caveats and common misconceptions, and suggest alternatives as appropriate. While we focus on terms specific to bats and disease ecology, we present a more general framework for addressing miscommunication that can be applied to other topics and disciplines to facilitate more effective research, problem-solving, and public policy.

There are a few existing studies on whether domestic migration improves China's pension system's fiscal sustainability in the context of rapid urbanization and industrialization. In this paper, we systematically investigate the impact of migration on the solvency of the worker's old-age insurance for urban employees by constructing actuarial and econometric models. We use panel data from 2002 to 2018, collected from 31 provinces in China. The results show that the association between migration and the solvency of pensions is an inverted-U shape along the urbanization process. Further regional comparison showed that the above-stated inverted-U curve is more pronounced in the central and western regions. We also established that the number of participants and the contribution base are the main contributors to these results. Our conclusions are important for future population policies and public pension systems in China., Competing Interests: The authors have declared that no competing interests exist.

Member states have consistently limited the European Union's competences in the area of health care reimbursement. Despite these efforts, there has been a slow but steady tendency toward harmonization of a key tool in reimbursement decision-making: health technology assessment (HTA), a multidisciplinary evaluation of "value for money" of medicines, devices, diagnostics, and interventions, which provides expert advice for reimbursement decisions. This article examines the origins of this paradoxical appetite for harmonization as well as of the dissensus that has, at the moment, somewhat stalled further integration in HTA. It finds that the prointegration neofunctionalist "permissive dissensus" is still present in decision making on HTA but potentially offset by dissensus or outright opposition from key actors, including member states and the medical device industry. These actors are able to decipher the potential consequences of highly technical issues, such as HTA, for national systems of social protection. Despite that, they have little interest in politicizing the issue, potentially opening the door to integrative policy solutions in the future., (Copyright © 2021 by Duke University Press.)

Objective: In this study, we aimed to clarify the transition to the implementation of smoking prohibition at eating and drinking establishments one year before and after April 2020, the time when they became "nonsmoking" in principle following the implementation of the amendment bill for the Health Promotion Act of Japan., Methods: The total number of nonsmoking/smoking eating and drinking establishments by industry were obtained using the data from "Tabelog ® ." The number of people who tested positive for COVID-19 by the polymerase chain reaction test on the day of the survey nationwide and the bankruptcy status of the companies (eating and drinking establishments, etc.) for each month were ascertained., Results: In 2020, a state of emergency was declared owing to the increase in the number of people positive for COVID-19, and many eating and drinking establishments went bankrupt. Despite these circumstances, the number of nonsmoking eating and drinking establishments exceeded that of smoking establishments in March 2020 and continued to increase thereafter. Additionally, the number of nonsmoking "restaurants" increased and exceeded that of smoking restaurants in June 2020. The number of nonsmoking "cafes" already exceeded that of smoking "cafes" at the beginning of this survey and continued to increase. The number of nonsmoking "bars" increased, but that of smoking "bars" remained high., Conclusion: It is necessary to promote measures against passive smoking while paying attention to the trends for different types of eating and drinking establishments, rather than considering all establishments together.

After diagnosed in Wuhan, COVID-19 spread quickly in mainland China. Though the epidemic in regions outside Hubei in mainland China has maintained a degree of control, evaluating the effectiveness and timeliness of intervention strategies, and predicting the transmission risk of work resumption as well as lifting the lockdown in Hubei province remain urgent. A patch model reflecting the mobility of population between Hubei and regions outside Hubei is formulated, and parameterized based on multiple source data for Hubei and regions outside Hubei. The effective reproduction numbers for Hubei and regions outside Hubei are estimated as 3.59 and 3.26 before Jan 23rd, 2020, but decrease quickly since then and drop below 1 after Jan 31st and Jan 28th, 2020. It is predicted that the new infections in Hubei province will decrease to very low level in mid-March, and the final size is estimated to be about 68,500 cases. The simulations reveal that contact rate after work resumption or lifting the lockdown in Hubei plays a critical role in affecting the epidemic. If the contact rate could be kept at a relatively low level, work resumption starting as early as on March 2nd in Hubei province may not induce the secondary outbreak, and the daily new infectious cases can be controlled at a low level if the lockdown in Hubei is liftted after March 9th, otherwise both work resumption and lifting the lockdown in Hubei should be postponed., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

In this work, we present a diagnostic analysis of strengths, weaknesses, opportunities and threats (SWOT) of the current state of Bioinformatics in Mexico. We conducted semi-structured interviews among researchers and academics with key expertise in this field, identified by bibliometric analyses and qualitative sampling techniques. Additionally, an online survey was conducted reaching a higher number of respondents. Among the relevant findings of our study, the lack of specialized human resources and technological infrastructure stood out, along with deficiencies in the number and quality of academic programs, scarce public investment and a weak relationship between public and private institutions. However, there are great opportunities for developing a national Bioinformatics to support different economic sectors. In our opinion, this work could be useful to favor a comprehensive network among Mexican researchers, in order to lay the foundations of a national strategy towards a well designed public policy., Competing Interests: The authors have declared that no competing interests exist.

The coronavirus disease 2019 (COVID-19) pandemic is straining public health systems worldwide, and major non-pharmaceutical interventions have been implemented to slow its spread 1-4 . During the initial phase of the outbreak, dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was primarily determined by human mobility from Wuhan, China 5,6 . Yet empirical evidence on the effect of key geographic factors on local epidemic transmission is lacking 7 . In this study, we analyzed highly resolved spatial variables in cities, together with case count data, to investigate the role of climate, urbanization and variation in interventions. We show that the degree to which cases of COVID-19 are compressed into a short period of time (peakedness of the epidemic) is strongly shaped by population aggregation and heterogeneity, such that epidemics in crowded cities are more spread over time, and crowded cities have larger total attack rates than less populated cities. Observed differences in the peakedness of epidemics are consistent with a meta-population model of COVID-19 that explicitly accounts for spatial hierarchies. We paired our estimates with globally comprehensive data on human mobility and predict that crowded cities worldwide could experience more prolonged epidemics.

Objectives. To examine public support for health insurance, income support, and unemployment policies during the initial phase of disease transmission and economic distress following the coronavirus disease 2019 (COVID-19) outbreak and to assess varying public support based on beliefs about the role of government. Methods. We fielded a nationally representative survey of US adults (n = 1468) from April 7, 2020, to April 13, 2020. Results. Of US adults, 77% supported paid sick leave, and a majority also supported universal health insurance, an increased minimum wage, and various unemployment support policies. Public support for an active government role in society to improve citizens' lives increased by 10 percentage points during this initial pandemic response relative to September 2019. Belief in a strong governmental role in society was associated with greater support for social safety-net policies. Conclusions. During the initial phase of the COVID-19 pandemic in early April 2020, most US adults favored a range of safety-net policies to ameliorate its negative health and economic consequences. For most safety-net policies, public support was highest among those favoring a stronger governmental role in society.

The COVID-19 pandemic has exacerbated the flaws in the U.S. employer-based health insurance system, magnified racial disparities in health and health care, and overwhelmed the country's underfunded public health infrastructure. These are the same systematic failures that have always harmed and killed the nation's most vulnerable. While everyone wishes for an end to this national tragedy, the authors believe a new normal must be defined for the postpandemic period.In the postpandemic period, policies that were once labeled radical and impossible will be urgent and necessary. Examples of such policies include providing universal health care, dismantling the structures that propagate racism and injustice, and reinvesting in public health. Previous research by the authors has shown that their medical student colleagues recognize that it is their responsibility to address policies that harm patients and to support reforms at the scale the authors propose. This commitment to a better future is reflected in the widespread mobilization of medical students seen across the United States. Recognizing that the old normal is unsustainable, the authors call on those who previously benefited from the status quo to instead seek a new postpandemic normal that works for all.

One-fifth of the way through the 21st century, a commonality of factors with those of the last 50 years may offer the opportunity to address unfinished business and current challenges. The recommendations include: (1) Resisting the tendency to oversimplify scientific assessments by reliance on single disciplines in lieu of clear weight-of-evidence expressions, and on single quantitative point estimates of health protective values for policy decisions; (2) Improving the separation of science and judgment in risk assessment through the use of clear expressions of the range of judgments that bracket protective quantitative levels for public health protection; (3) Use of comparative risk to achieve the greatest gains in health and the environment; and (4) Where applicable, reversal of the risk assessment and risk management steps to facilitate timely and substantive improvements in public health and the environment. Lessons learned and improvements in the risk assessment process are applied to the unprecedented challenges of the 21st century such as, pandemics and climate change. The beneficial application of the risk assessment and risk management paradigm to ensure timely research with consistency and transparency of assessments is presented. Institutions with mandated stability and leadership roles at the national and international levels are essential to ensure timely interdisciplinary scientific assessment at the interface with public policy as a basis for organized policy decisions, to meet time sensitive goals, and to inform the public., (© 2020 Society for Risk Analysis.)

Objective: Governments' limited adoption of evidence-based policies to reduce alcohol-related harm has been partly attributed to alcohol industry influence. A better understanding of industry political strategy may help protect public policy against vested interests. We examined how industry actors used scientific evidence in their submissions to government alcohol policy consultations., Method: We conducted a content analysis of 214 submissions from industry actors in 21 Australian public consultations between 2013 and 2017. Represented industry actors included alcohol producers and retailers, trade associations, licensees, and associated entities that derive commercial benefit from alcohol (e.g., advertising companies). Adapting an existing framework, we classified industry practices into two categories: (a) misuse of evidence and (b) denial of the effectiveness of evidence-based strategies., Results: Almost all submissions (91%) denied the effectiveness of evidence-based strategies; the most common denial practices were making unsubstantiated claims about adverse effects of policies (76%) and promoting alternatives without evidence (71%). The misuse of scientific evidence was apparent in 66% of submissions. Trade associations, producers, and retailers were most likely to use such practices., Conclusions: The extent to which the examined industry actors misused scientific evidence in their submissions to a wide range of alcohol policy consultations in Australia suggests the need for governments to consider excluding the industry from consultation on the regulation of alcohol.

Conspiracy theories have been proliferating during the COVID-19 pandemic. Evidence suggests that belief in conspiracy theories undermines engagement in pro-health behaviors and support for public health policies. Moreover, previous work suggests that inoculating messages from opinion leaders that expose conspiracy theories as false before people are exposed to them can help to prevent belief in new conspiracies. Goals of this study were to: (a) explore associations between COVID-19 conspiracy beliefs with SARS-CoV-2 vaccine intentions, cooperation with public health recommendations, and support for public health policies among U.S. adults and (b) investigate trusted sources of COVID-19 information to inform strategies to address conspiracy beliefs. A cross-sectional, online survey was conducted with 845 U.S. adults in April 2020. Data were analyzed using analyses of variance and multivariable regressions. One-third (33%) of participants believed one or more conspiracies about COVID-19. Participants who believed conspiracies reported that their intentions to vaccinate were 3.9 times lower and indicated less support for COVID-19 public health policies than participants who disbelieved conspiracies. There were no differences in cooperation with public health recommendations by conspiracy belief endorsement in the multivariable regression analysis. Although there were some key differences in trusted sources of COVID-19 information, doctor(s) were the most trusted source of information about COVID-19 overall with 90% of participants trusting doctor(s). Doctor(s) may play a role in addressing COVID-19 conspiracy theories before people are exposed to them to promote COVID-19 prevention efforts., (© Society of Behavioral Medicine 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Recent guidance from the US Immigration and Customs Enforcement drastically altered the lives of international students in America, especially those who are matriculating. This commentary describes how international students still face uncertainty concerning their visa statuses and their place in American society., (© 2020 The Author(s).)

Objectives: To identify the corporate political activity (CPA) of food industry actors in South Africa., Methods: We studied the CPA of ten different food actors for the period Jan 2018-April 2019. We used a systematic approach and existing framework to collect and analyse information available in the public domain, including material from the industry, government, academia and civil society., Results: Food industry actors in South Africa established multiple relationships with various parties in and outside the South African government. These included interactions between large food companies and the Department of Basic Education, the Department of Sport & Recreation, the Department of Health, and the Department of Agriculture. In addition, the food industry-sponsored community programs, with a focus on poverty alleviation and undernutrition. Moreover, food industry actors influenced science were directly involved in policy-making and helped frame the debate on diet and public health in South Africa., Conclusions: It is crucial that there is increased transparency, disclosure, and awareness of industry strategies, and that mechanisms to address and manage industry influence are strengthened in the country.

Background: Obesity has become a worldwide health problem, caused by multiple and complex factors. To face this challenge, governments have played a central role in combating its rise. Considering this, public policies are introduced or enacted for the benefit of whole populations, taking into account the perspective of multiverse social stakeholders based on solid scientific fundamentals., Objective: The aim of this study was to examine obesity-related public policies in the United States and the District of Columbia, in order to understand their scientific basis., Methods: We analyzed the public policies implemented in the United States from 2003 to 2013, during which time the largest number of obesity-related public policies were introduced, using text mining., Results: In total, 1592 obesity-related public policies were retrieved from the Centers for Disease Control and Prevention. Multidisciplinary policies were predominant in the documents analyzed (533/1592, 33.5%), followed by health sciences (454/1592, 28.5%), social sciences (330/1592, 20.7%), life sciences (240/1592, 15.1%), and physical sciences (35/1592, 2.2%). Throughout the country, most policies were community oriented (1082/1865, 58.0%) and many of them were related to school and family environments (447/1865, 24.0%), early care and education (75/1865, 4.0%), hospitals (63/1865, 3.4%), and workplaces (47/1865, 2.5%)., Conclusions: The contents of obesity-related public policies were generally uniformly framed across the United States. They were generally based on scientific references, in which there was a predominance of multidisciplinary research. These findings are consistent with what is known about the multiple factors causing obesity and about the methods being developed to control the epidemic., (©Caroline Spanhol-Finocchio, Mariana de Freitas Dewes, Giana de Vargas Mores, Homero Dewes. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 29.07.2020.)

Background: Germany is known for its weak tobacco control. We aimed to provide projections of potentially avoidable cancer cases under different tobacco control policy intervention scenarios., Methods: To estimate numbers and proportions of potentially avoidable cancer cases under different policy intervention scenarios (cigarette price increases, comprehensive marketing ban, and plain packaging), we calculated cancer site-specific potential impact fractions by age, sex, and year of study period (2020-2050), considering latency periods between reduction in smoking prevalence and manifestation in declining cancer excess risks. To obtain estimates of future incident case numbers, we assumed a continuation of recent smoking trends, and combined German cancer registry data with forecasted population sizes, published effect sizes, and national daily smoking prevalence data., Results: Over a 30-year horizon, an estimated 13.3% (men 14.0% and women 12.2%) of smoking-related cancer cases could be prevented if a combination of different tobacco control policies were to be implemented in Germany, with repeated price increases being the most effective single policy (men 8.5% and women 7.3%). Extensive sensitivity analyses indicated that the model is fairly robust., Conclusions: Our results suggest that the expected cancer incidence in Germany could be considerably reduced by implementing tobacco control policies as part of a primary cancer prevention strategy., Impact: Our straightforward modeling framework enables a comparison of the impact of different health policy measures. To further accelerate the currently observed tentative trend of declining smoking prevalence in Germany and thereby curtail smoking-related cancer incidence, there is a great need to urgently intensify efforts in tobacco control., (©2020 American Association for Cancer Research.)

New York City is currently experiencing an outbreak of COVID-19, a highly contagious and potentially deadly virus, which is particularly dangerous for older adults. This pandemic has led to public health policies including social distancing and stay-at-home orders. We explore here the impact of this unique crisis on victims of elder mistreatment and people at risk of victimization. The COVID-19 outbreak has also had a profound impact on the organizations from many sectors that typically respond to protect and serve victims of elder mistreatment. We examine this impact and describe creative solutions developed by these organizations and initial lessons learned in New York City to help inform other communities facing this pandemic and provide guidance for future crises.

: The United States is currently in the midst of 2 public health emergencies: COVID-19 and the ongoing opioid crisis. In an attempt to reduce preventable harm to individuals with opioid use disorder (OUD), federal, state, and local governments have temporarily modified law and policy to increase access to OUD treatment and divert some individuals at high risk away from the correctional system. In this Commentary, we briefly describe how people with OUD are at increased risk for COVID-19, discuss existing policy barriers to evidence-based prevention and treatment for individuals with OUD, explain the temporary rollbacks of those barriers, and argue that these changes should be made permanent. We also suggest several additional steps that federal and state governments can urgently take to reduce barriers to care for individuals with OUD, both during the current crisis and beyond.

This summary article compares government revenue from the sale and distribution of alcohol to the societal costs caused by alcohol use for the year 2014. Statistics Canada data reported government revenue of $10.9 billion; however, this was offset by net societal costs of $14.6 billion, as reported by Canada's national substance use surveillance system, the Canadian Substance Use Costs and Harms project. The societal costs include health care, economic loss of production, criminal justice and other direct costs. Though revenue from alcohol sales has been described as a benefit to public coffers, accounting that includes costs incurred shows that all provinces and territories in Canada are running an alcohol deficit, totalling $3.7 billion nationally., Competing Interests: None.

This special issue on substance use issues comes at a critical time for Canadian health policy makers and researchers. Most attention is currently focussed on the opioid crisis and the potential impacts of cannabis legalization. However, our most widely used and harmful substances continue to be alcohol and nicotine. Our policies to reduce harms from these substances are failing. While alcohol control policies are being gradually abandoned, opportunities to maximize the harm reduction potential of new, alternative and safer nicotine delivery devices are not being grasped. More generally, a greater focus is needed on harm reduction strategies that are informed by the experience of marginalized people with severe substance use-related problems so as to not exacerbate health inequities. In order to better inform policy responses, we recommend innovative approaches to monitoring and surveillance that maximize the use of multiple data sources, such as those used in the Canadian Substance Use Costs and Harms (CSUCH) project. Greater attention to precision in defining patterns of risky use and harms is also needed to support policies that more accurately reflect and respond to actual levels of substance use-related harm in Canadian society., Competing Interests: None.

Background: The One-Child Policy led to the imbalance of the sex ratio at birth (SRB) in China. After that, Two-Child Policy was introduced and gradually liberalized at three stages. If both the husband and wife of one couple were the only child of their parents, they were allowed to have two children in policy (BTCP). If only one of them was the only child, they were allowed to have two children in policy (OTCP). The Universal Two-Child Policy (UTCP) allowed every couple to have two children. The objective of this study was to explore the changing trend of SRB at the stages of Two-Child Policy, to analyze the effect of population policy on SRB in terms of maternal age, delivery mode, parity, maternal education, delivery hospital, and to figure out what factors have greater impact on the SRB., Methods: The data of the study came from Hebei Province Maternal Near Miss Surveillance System, covered the parturients delivered at 28 gestation weeks or more in 22 hospitals from January 1, 2013 to December 31, 2017. We compared the SRB at different policy stages, analyzed the relationship between the SRB and population policy by logistic regression analysis., Results: Total 270,878 singleton deliveries were analyzed. The SRB, 1.084 at BTCP, 1.050 at OTCP, 1.047 at UTCP, declined rapidly (χ 2  = 15.97, P < 0.01). With the introduction of Two-Child Policy, the percentage of parturients who were 30-34, ≥35 years old rose significantly, and the percentage of multiparous women increased significantly (40.7, 47.2, 56.6%). The neonatal mortality declined significantly (8.4‰, 6.7‰, 5.9‰, χ 2  = 44.49, P < 0.01), the mortality rate of female infant gradually declined (48.2, 43.7, 43.9%). The logistic regression analysis showed the SRB was correlated to the three population policy stages in terms of maternal age, delivery mode, parity, maternal education, delivery hospital., Conclusions: The SRB has declined to normal level with the gradually liberalizing of Two-Child Policy in China. Advanced maternal age, cesarean delivery, multiparous women, middle level education, rural hospital are the main factors of effect on the decline of the SRB.

Objective: to construct a theoretical, field and analysis mapping of nursing education in the context of public education policies in Brazil., Method: a descriptive study with a mixed approach of investigation, having as theoretical-analytical instruments the studies on maps construction (theoretical, field and analytical), which allowed the distribution, imbalances, tendencies and contradictions verification of the phenomenon studied., Results: the disordered expansion of vacancies in nursing has been occurring in a disorganized, asymmetric way and directed to the distancing of the State in the assistance to the educational sector, as well as the consequent privatization of education and reaffirmation of social imbalance of regions with the lowest economic power., Final Considerations: the study made technological, scientific and academic contributions possible and showed that public policies directed intense and disorderly expansion of courses/vacancies, indicating the need to establish strategies that can promote actions to strengthen the quality of nursing education.

Purpose: This study explored employer's perspectives on (1) their experience of good practice related to workers diagnosed with cancer and their return to work (RTW), and (2) their perceived needs necessary to achieve good practice as reported by employers from nine separate countries., Methods: Twenty-five semi-structured interviews were held in eight European countries and Israel with two to three employers typically including HR managers or line managers from both profit and non-profit organisations of different sizes and sectors. Interviews were recorded and transcribed verbatim. A grounded theory/thematic analysis approach was completed., Results: Employers' experience with RTW assistance for workers with cancer appears to be a dynamic process. Results indicate that good practice includes six phases: (1) reacting to disclosure, (2) collecting information, (3) decision-making related to initial actions, (4) remaining in touch, (5) decision-making on RTW, and (6) follow-up. The exact details of the process are shaped by country, employer type, and worker characteristics; however, there was consistency related to the need for (1) structured procedures, (2) collaboration, (3) communication skills training, (4) information on cancer, and (5) financial resources for realizing RTW support measures., Conclusions: Notwithstanding variations at country, employer, and worker levels, the employers from all nine countries reported that good practice regarding RTW assistance in workers with a history of cancer consists of the six phases above. Employers indicate that they would benefit from shared collaboration and resources that support good practice for this human resource matter., Implications for Cancer Survivors: Further research and development based on the six phases of employer support as a framework for a tool or strategy to support workers with a history of cancer across countries and organisations is warranted.

Research and innovation in biomedicine and health care increasingly depend on electronic data. The emergence of data-driven technologies and associated digital transformations has focused attention on the value of such data. Despite the broad consensus of the value of health data, there is less consensus on the basis for that value; thus, the nature and extent of health data value remain unclear. Much of the existing literature presupposes that the value of data is to be understood primarily in financial terms, and assumes that a single financial value can be assigned. We here argue that the value of a dataset is instead relational; that is, the value depends on who wants to use it and for what purposes. Moreover, data are valued for both nonfinancial and financial reasons. Thus, it may be more accurate to discuss the values (plural) of a dataset rather than the singular value. This plurality of values opens up an important set of questions about how health data should be valued for the purposes of public policy. We argue that public value models provide a useful approach in this regard. According to public value theory, public value is created, or captured, to the extent that public sector institutions further their democratically established goals, and their impact on improving the lives of citizens. This article outlines how adopting such an approach might be operationalized within existing health care systems such as the English National Health Service, with particular focus on actionable conclusions., (©James Wilson, Daniel Herron, Parashkev Nachev, Nick McNally, Bryan Williams, Geraint Rees. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 27.03.2020.)

Objective: U.S. policymakers and public health practitioners lack composite indicators (indices) to assess and compare the restrictiveness of state-level alcohol policy environments, conceptualized as the presence of multiple policies in effect in a particular place and time. The purposes of this study were to characterize the alcohol policy environment in each U.S. state and Washington, DC, in 2018, and to examine changes during the past 20 years., Method: State-specific Alcohol Policy Scale (APS) scores from 1999 to 2018 were based on 29 policies, after weighting each present policy by its efficacy and degree of implementation. Modified APS scores were also calculated on the basis of two sets of mutually exclusive policy subgroups., Results: APS scores in 2018 varied considerably between states, ranging from 25.6 to 67.9 on a theoretical scale of 0 to 100; the median score was 43.5 (based on a 0-100 range), and 43 states had scores less than 50. The median change in state APS scores from 1999 to 2018 was positive (+4.9, range: -7.4 to +10.3), indicating increases in the restrictiveness of policy environments, with decreases in only five states. The increases in APS scores were primarily attributable to the implementation of stronger impaired-driving laws, whereas policies to reduce excessive drinking were unchanged. There was no correlation between states' excessive drinking policy scores and their impaired-driving scores (r = .05, p = .74)., Conclusions: Based on this policy scale, few states have restrictive policy environments. Although states adopted policies targeting impaired driving during the study period, there was no change in policies to reduce excessive drinking.

This case study details a 2018 "near miss" school mass-shooting event in Vermont that involved a former student and occurred contemporaneously with the Parkland, Florida, tragedy. The situation "jolted" this rural state's governor, lending urgency to the need to enact sensible gun control laws. He comes to support a series of proactive bills already in the legislature and advocate for further preventive strategies. The state's commissioner of health plays public health's traditional role within state government as trusted health promotion and education resource to frame the issue in public health and public safety terms. He portrayed health data on firearm injuries and deaths and formed a public health strategy including surveillance, identification of risk factors, and resources for school- and community-based prevention. On April 11, 2018, Governor Phil Scott signed a package of gun-related legislation that included increasing the legal age for gun purchases, expanding background checks for private gun sales, banning high-capacity magazines and rapid-fire bump stocks, and extreme risk protection orders. The final results were examined from an evidence-based public health standpoint, acknowledging the lack of gun research by federal agencies since the 1996 enactment of the Dickey Amendment that prohibits the Centers for Disease Control and Prevention from conducting firearms-related research. The case study illustrates the paradox of moving forward on gun safety, where more research is needed, but research does not necessarily influence political leaders or policy. It also demonstrates how prevention of gun violence can be portrayed in a public health framework, drawing upon data and strategies used in upstream preventive efforts in areas such as early childhood development, mental health, and substance misuse.

A key focus of recent policy efforts to curb tobacco product usage has been the role of place-specifically the density of retail and advertising and the resulting spatial pattern of access and exposure for consumers. Policies can alter the environment by reducing density or shifting distribution of tobacco retail and thus limiting access and exposure. Since little empirical evidence exists for the potential impact of these policies across potentially heterogeneous places, we develop and apply an original spatial computational model to simulate place-based retail tobacco control policies. The model is well-grounded in theory and available empirical evidence. We apply the model in four representative settings to demonstrate the utility of this approach as a policy laboratory, to develop general insights on the relationship between retailer density, retail interventions, and tobacco costs incurred by consumers, and to provide a framework to guide future modeling and empirical studies. Our results suggest that the potential impact on costs of reducing tobacco retailer density are highly dependent on context. Projected impacts are also influenced by assumptions made about agent (smoker) purchasing decision-making processes. In the absence of evidence in this area, we tested and compared three alternative decision rules; these interact with environmental properties to produce different results. Agent properties, namely income and cigarettes per day, also shape purchasing patterns before and after policy interventions. We conclude that agent-based modeling in general, and Tobacco Town specifically, hold much potential as a platform for testing and comparing the impact of various retail-based tobacco policies across different communities. Initial modeling efforts uncover important gaps in both data and theory and can provide guidance for new empirical studies in tobacco control., (Copyright © 2019. Published by Elsevier Ltd.)