Policies in Canada fail to address disparities in access to person-centred osteoarthritis care: a content analysis

BACKGROUND

Women are disproportionately impacted by osteoarthritis (OA) but less likely than men to access OA care, particularly racialized women. One way to reduce inequities is through policies that can influence healthcare services. We examined how OA-relevant policies in Canada address equitable, person-centred OA care for women.

METHODS

We used content analysis to extract data from English-language OA-relevant documents referred to as policies or other synonymous terms published in 2000 or later identified by searching governmental and other web sites. We used summary statistics to describe policy characteristics, person-centred care using McCormack's six-domain framework, and mention of OA prevalence, barriers and strategies to improve equitable access to OA care among women.

RESULTS

We included 14 policies developed from 2004 to 2021. None comprehensively addressed all person-centred care domains, and few addressed individual domains: enable self-management (50%), share decisions (43%), exchange information (29%), respond to emotions (14%), foster a healing relationship (0%) and manage uncertainty (0%). Even when mentioned, content offered little guidance for how to achieve person-centred OA care. Few policies acknowledged greater prevalence of OA among women (36%), older (29%) or Indigenous persons (29%) and those of lower socioeconomic status (14%); or barriers to OA care among those of lower socioeconomic status (50%), in rural areas (43%), of older age (37%) or ethno-cultural groups (21%), or women (21%). Four (29%) policies recommended strategies for improving access to OA care at the patient (self-management education material in different languages and tailored to cultural norms), clinician (healthcare professional education) and system level (evaluate OA service equity, engage lay health leaders in delivering self-management programs, and offer self-management programs in a variety of formats). Five (36%) policies recommended research on how to improve OA care for equity-seeking groups.

CONCLUSIONS

Canadian OA-relevant policies lack guidance to overcome disparities in access to person-centred OA care for equity-seeking groups including women. This study identified several ways to strengthen policies. Ongoing research must identify the needs and preferences of equity-seeking persons with OA, and evaluate the impact of various models of service delivery, knowledge needed to influence OA-relevant policy.

The impact of unmet treatment need on oral health related quality of life: a questionnaire survey

BACKGROUND

Based on the present global burden of oral diseases, unmet dental needs affect a more significant population worldwide. It is characterised by the need for dental care but receiving delayed or no care. The contributing factors include lack of knowledge about oral health, its consequences, and the availability of dental services. We need to find out the scale of the problem of unmet dental needs for the south Indian population. Therefore, the objective was to determine the relationship between the presence of oral disease and the quality of life-related to oral health using the OHIP-14 tool.

METHODS

The unmet dental requirements of the south Indian population were determined using a cross-sectional questionnaire survey. Close-ended questions were used to obtain data from two investigators trained to record the answers from the patients. The data was collected using the OHIP-14 questionnaire, which consists of 14 items divided into seven domains with two questions each. Physical pain, psychological impairment, physical disability, psychological disability, social disability, and disability were all considered. An additional analysis of artificial neural network (ANN) was done.

RESULTS

The response rate was 100 per cent. N = 1029 people replied to the questionnaire about their unmet dental needs. N = 497 (48.3%) were men, whereas N = 532 (51.7%) were women. The average age was 31.7811.72. As their current occupation, most of the included subjects (60.1%) were students. The respondents had no known personal habits and a mixed diet (94.93%). The average BMI was 24.022.59 (14-30.9). OHIP was present in 62.3% of the population. The average OHIP-14 severity score was 10.97. (8.54). The severity and degree of unmet dental need were substantial (p0.01) due to pain in the mouth/teeth/gums, malocclusion, and gum bleeding. The most common OHIP-14 domains affected by unmet oral needs were psychological discomfort, psychological limitation, social limitation, and feeling handicapped. The analysis of ANN revealed that high OHIP scores were primarily attributed to dental caries, poor oral health, and dental aesthetics.

CONCLUSION

The severity and degree of unmet dental needs were significant among the south Indian population. The most common oral health status that impacted OHIP-14 domains were pain, malocclusion, and bleeding gums. These patients were significantly impacted by psychological discomfort and social limitations and felt handicapped.

Differences in Antenatal Care Policies in England, Finland, and the Netherlands: A Framing analysis

BACKGROUND AND PURPOSE

The World Health Organization (WHO) states that good quality antenatal care should strive for both mother and child achieving their best possible health. On a policy level, in Europe these goals are reached with varying approaches. This research offers a fresh look on the underlying assumptions embedded in the ANC policies in three European countries.

METHODS

A framing analysis was conducted to publicly available ANC policies on uncomplicated pregnancies in Finland, England, and the Netherlands. Analysis was guided by van Hulst and Yanowa and included the following phases: a) Sense-making, b) Selecting, naming, and categorizing and c) Storytelling.

MAIN FINDINGS

Findings of this study demonstrate how ANC is organized with distinct frames. The Finnish ANC policies emphasized equity in care and instead of focusing on women, the ANC focused on the family. In England the pregnant woman was central, and it is seen as her responsibility to understand the ANC protocols. The ANC in the Netherlands focused on the pregnant woman's pregnancy experience and freedom.

CONCLUSION

The three studied countries had individual priorities and values guiding ANC provision. Despite each country being in line with the WHO ANC recommendations, areas requiring improvement should not be overlooked.

Defining the maximum nitrogen surplus in water management plans to recover nitrate polluted aquifers in Spain

Nitrate pollution in aquifers is a global concern. Spain has developed a national strategy to recover nitrate polluted aquifers aligned with the European Union (EU) policies, specifically through the water planning under the EU Water Framework Directive. River basin management plans use PATRICAL model results to define the maximum nitrogen surplus in each polluted aquifer for the first time. The maximum nitrogen surplus allows to reach the good status in each aquifer and the model provides the number of years required. Around 30% of the aquifers in Spain is currently heavily polluted by nitrates. Model results show that 90% of these aquifers can be recovered in next 6-12 years by increasing nitrogen use efficiency and reducing nitrogen losses around 50%, which is in line with the EU Farm to Fork Strategy. The remaining aquifers require additional reductions to achieve the good status. In Spain this increase in nitrogen efficiency can be obtained with different measures including 30% reduction of current fertilization.

Policy Evolution and Lessons Learned from China's Efforts to Eliminate Leprosy

The prevention and treatment of leprosy is a public health and social issue of global concern. China has become the first country in the world to put forward a proposal on the elimination of the harm caused by leprosy. This paper briefly introduces the status of the spread of leprosy in China, and systematically reviews the evolution of policies and measures at different stages of the disease in China, from the serious epidemic of leprosy to the control of the infection, to the basic elimination, and to the elimination of the hazards. On this basis, five main lessons learned from the control and elimination of leprosy in China were also summarized. These provide the basis for promoting the complete global elimination of leprosy and preventing its re-transmission, thereby benefiting all those who still suffer from the scourge of leprosy.

Visa relaxation policies and Potential implications on public health in Africa

In this article, we explore how Africa’s visa relaxation policies could transform public health landscapes, with the potential of increasing access to healthcare and collaborative disease control, while also posing challenges in managing infectious disease spread amidst already porous borders. We also suggest recommendations to some of the challenges.

State Level Policies on First Responder Mental Health in the U.S.: A Scoping Review

A growing body of evidence demonstrates potential adverse mental health outcomes associated with exposure to occupational trauma among first responders. In response, policymakers nationwide are eager to work on these issues as evidenced by the number of states covering or considering laws for mental health conditions for first responders. Yet, little information exists to facilitate understanding of the impact of mental health-related policies in the United States on this important population. This study aims to identify and synthesize relevant state-level policies and related research on first responder mental health in the United States. Using a scoping review framework, authors searched the empirical and policy literature. State level policies were identified and grouped into two categories: (1) Workers' Compensation-related policies and (2) non-Workers' Compensation (WC) related policies. While benefits levels and other specifics vary greatly by state, 28 states cover certain first responder mental health claims under WC statutes. In addition, at the time of this study, 28 states have policies governing first responder mental health outside of WC. Policies include requiring mental health assessments, provisions for counseling and critical incident management, requiring education and training, providing funding to localities for program development, bolstering peer support initiatives and confidentiality measures, and establishing statewide offices of responder wellness, among others. Authors found a dearth of outcomes research on the impact of state level policies on first responder mental health. Consequently, more research is needed to learn about the direct impact of legislation and establish best practice guidelines for implementing state policy on first responder mental health. By conducting systematic evaluations, researchers can lay the foundation for an evidence-based approach to develop more integrated systems that effectively deliver and finance mental health care for first responders who experience work-related trauma. Such evaluations are crucial for building an understanding of the impact of policies and facilitating improvements in the support provided to first responders in managing mental health challenges arising from their work.

Are advertising policies affirmative in restricting the marketing of foods high in fat, salt and sugar (HFSS) in India?: evidence from SWOT Analysis

The regulatory Indian environment for advertising high fat, salt, and sugar (HFSS) foods and non-alcoholic beverages, on various media was reviewed. Identified national-level policies were categorised as mandatory or self-regulatory based on legal content. For each mandatory regulation, Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was undertaken to determine how existing policies could be strengthened to safeguard children from unhealthy food advertisements. Thirteen policies (nine mandatory; four self-regulatory) relevant to advertising in India were identified. Of the nine mandatory policies, Guidelines for Prevention of Misleading Advertisements and Endorsements for Misleading Advertisements, 2022, is the only policy that restricts HFSS food advertisements to children across all media. There are key shortfalls, including limited scope of 'child-targeted' advertisements and lack of criteria to define HFSS foods. A robust regulatory framework is needed to protect children from HFSS food marketing, not just what is 'directed' at them, with clear evidence-based food classification criteria.

ChatGPT in finance: Applications, challenges, and solutions

The emergence of ChatGPT, a generative artificial intelligence tool, has sparked a revolution in the finance industry, enabling individuals to interact with technology in natural language. However, the use of ChatGPT in finance presents a profound array of ethical considerations that demand careful scrutiny to ensure its responsible and ethical use. After a concise exploration of ChatGPT's applications in finance, this policy article delves into the ethical challenges arising from the use of ChatGPT in finance, including outcomes contaminated with biases, incorporation of fake information in the financial decisions, concerns surrounding privacy and security, lack of transparency and accountability in the decision-making processes and financial services, human job displacement, and the intricate web of legal complexities. Our article asserts that financial institutions employing ChatGPT must proactively devise strategies to confront these burgeoning challenges, mitigating their adverse effects on both individuals and society as a whole. Additionally, we propose relevant policies to tackle these ethical quandaries head-on. In essence, this article illuminates the imperative need for a meticulous ethical framework, facilitating an informed and responsible use of ChatGPT in the realm of finance, safeguarding the welfare of individuals and society. While our work significantly contributes to the research and practice of finance, we also identify future research avenues.

Waterborne Diseases and Wastewater Treatment in Iraq

Iraq is a desert country with access to large river resources and an extensive aquifer, but these have already been overdrawn for domestic, industry and agriculture use. The diminished flow of the Tigris and Euphrates rivers has allowed seawater intrusion from the Persian Gulf 110 km up as far as Basra, the county's third largest city. In addition, water distribution systems are overloaded and wastewater treatment plants (WWTPs) need upgrading, and fresh water sources polluted by lack of sanitation, agricultural runoff, household and industrial waste, and including the irrigation of vegetables with sewage water, have led to episodes of bacterial, viral and parasitic diseases. Also, there have been increases in many types of cancer since the early 1990s, and based on clinical and epidemiological data, these increases could be attributable to exposure to depleted uranium in the environment arising from conflict in Iraq and particularly during the Iraqi War started 20 years ago. The population affected would like government action to reduce their health concerns, and policies that have been proposed for improving water availability and quality, as well as but have not been followed up sufficiently to tackle these, including increasing the capacity and efficiency of WWTP; promoting the most efficient irrigation techniques for the local growing conditions; reducing the use of chemical fertilizers and pesticides that can decrease the water quality; reducing saline intrusion challenges; building compact desalination units; constructing water storage facilities to address water scarcity challenges; and establishing public education plans for consumers to reduce the water demand during the hot season. Whether the government rises to the task remains to be seen. Also, do those countries that used the DU have a responsibility to remove or otherwise dispose of the fragments that remain?

The politics of COVID-19: Differences between U.S. red and blue states in COVID-19 regulations and deaths

The study investigated infection variables and control strategies in 2020 and 2021 and their influence on COVID-19 deaths in the United States, with a particular focus on comparing red (Republican) and blue (Democratic) states. The analysis reviewed cumulative COVID-19 deaths per 100,000 by year, state political affiliation, and a priori latent factor groupings of mitigation strategies (lockdown days in 2020, mask mandate days, vaccination rates), social demographic variables (ethnicity, poverty rate), and biological variables (median age, obesity). Analyses first identified possible relationships between all assessed variables using K-means clustering for red, blue, and purple states. Then, a series of regression models were fit to assess the effects of mitigation strategies, social, and biological factors specifically on COVID-19 deaths in red and blue states. Results showed distinct differences in responding to COVID infections between red states to blue states, particularly the red states lessor adoption of mitigation factors leaving more sway on biological factors in predicting deaths. Whereas in blue states, where mitigation factors were more readily implemented, vaccinations had a more significant influence in reducing the probability of infections ending in death. Overall, study findings suggest politicalization of COVID-19 mitigation strategies played a role in death rates across the United States.

Building the Science of Physical Therapy: Conundrums and a Wicked Problem

Producing science that supports the physical therapist profession in all its endeavors is critical to ensure that the best evidence is used in practice and education. In this Perspective, numerous conundrums are discussed that can constrain efforts to be productive in research in the academic institutions that serve as the intellectual centers of the discipline. Taken together, these conundrums and the conditions that create them collectively contribute to the wicked problem of how to generate sufficient evidence to support the practice of physical therapy. In response, this Perspective recommends changes in the Standards and Elements of the Commission on Accreditation in Physical Therapy Education to support the importance of faculty research, reconfigure the rules for faculty composition, and introduce a new metric of productivity that reinforces the need of all programs to produce evidence for the profession, while still allowing flexibility and institutional prerogative to govern how this need is expressed.

Breastfeeding and human milk in the NICU: From birth to discharge

It is well recognized that human milk is the optimal nutritive source for all infants, including those requiring intensive care. This statement reviews evidence supporting the importance of breastfeeding and human milk for infants, and why breastfeeding practices should be prioritized in the neonatal intensive care unit (NICU). It also reviews how to optimally feed infants based on their stability and maturity, and how to support mothers to establish and maintain milk production when their infants are unable to feed at the breast.

A state-of-art-review on emerging contaminants: Environmental chemistry, health effect, and modern treatment methods

Pollution problems are increasingly becoming e a priority issue from both scientific and technological points of view. The dispersion and frequency of pollutants in the environment are on the rise, leading to the emergence have been increasing, including of a new class of contaminants that not only impact the environment but also pose risks to people's health. Therefore, developing new methods for identifying and quantifying these pollutants classified as emerging contaminants is imperative. These methods enable regulatory actions that effectively minimize their adverse effects to take steps to regulate and reduce their impact. On the other hand, these new contaminants represent a challenge for current technologies to be adapted to control and remove emerging contaminants and involve innovative, eco-friendly, and sustainable remediation technologies. There is a vast amount of information collected in this review on emerging pollutants, comparing the identification and quantification methods, the technologies applied for their control and remediation, and the policies and regulations necessary for their operation and application. In addition, This review will deal with different aspects of emerging contaminants, their origin, nature, detection, and treatment concerning water and wastewater.

Microplastics in the environment: An urgent need for coordinated waste management policies and strategies

Microplastics (MPs) have become a prevalent environmental concern, exerting detrimental effects on marine and terrestrial ecosystems, as well as human health. Addressing this urgent issue necessitates the implementation of coordinated waste management policies and strategies. In this study, we present a comprehensive review focusing on key results and the underlying mechanisms associated with microplastics. We examine their sources and pathways, elucidate their ecological and human health impacts, and evaluate the current state of waste management policies. By drawing upon recent research and pertinent case studies, we propose a range of practical solutions, encompassing enhanced recycling and waste reduction measures, product redesign, and innovative technological interventions. Moreover, we emphasize the imperative for collaboration and cooperation across sectors and jurisdictions to effectively tackle this pressing environmental challenge. The findings of this study contribute to the broader understanding of microplastics and provide valuable insights for policymakers, researchers, and stakeholders alike.

Understanding the barriers and facilitators related to birthing pool use from organisational and multi-professional perspectives: a mixed-methods systematic review

AIMS

To identify and synthesize the evidence regarding the facilitators and barriers relating to birthing pool use from organizational and multi-professional perspectives.

DESIGN

A systematic integrated mixed methods review was conducted.

DATA SOURCES

MEDLINE, CINAHL, PsychINFO, EMCARE, PROQUEST and Web of Science databases were searched in April 2021, March 2022 and April 2024. We cross-referenced with Google Scholar and undertook reference list searches.

REVIEW METHODS

Data were extracted from studies meeting the inclusion criteria. Barriers and facilitators to birthing pool use were mapped and integrated into descriptive statements further synthesized to develop overarching themes.

RESULTS

Thirty seven articles (29 studies) were included-quantitative (12), qualitative (8), mixed methods (7), and audits (2), from 12 countries. These included the views of 9,082 multi-professionals (midwives, nurses, obstetricians, neonatologists, students, physicians, maternity support workers, doulas and childbirth educators). Additionally, 285 institutional policies or guidelines were included over 9 papers and 1 economic evaluation. Five themes were generated: The paradox of prescriptiveness, The experienced but elusive practitioner, Advocacy and tensions, Trust or Trepidation and It's your choice, but only if it is a choice. These revealed when personal, contextual, and infrastructural factors were aligned and directed towards the support of birth pool use, birthing pool use was a genuine option. Conversely, the more barriers that women and midwives experienced, the less likely it was a viable option, reducing choice and access to safe analgesia.

CONCLUSION

The findings demonstrated a paradoxical reality of water immersion with each of the five themes detailing how the "swing" within these factors directly affected whether birthing pool use was facilitated or inhibited.

Mapping of nutrition policies and programs in South Asia towards achieving the Global Nutrition targets

BACKGROUND

South Asia continues to host the triple burden of child malnutrition with high levels of child undernutrition, hidden hunger (micronutrient deficiencies) and childhood overweight/obesity. To combat malnutrition, the international community along with the National governments have launched initiatives to track the country's progress towards achieving the Global Nutrition targets by 2025. This review captures the country-specific efforts of nutrition-specific and nutrition-sensitive sectoral programs and policies towards achieving these targets for eight South Asian countries.

METHODS

A systematic internet search was undertaken to search relevant policies and programs from Government websites and twelve International Organisations working in the region. The authors developed a template to map the policies against the following criteria: (i) enabling supportive environment; (ii) Initiatives targeted at nutrition-specific interventions; and (iii) Initiatives targeted at nutrition-specific interventions that impact child malnutrition. A narrative descriptive approach was used to present findings.

RESULTS

All eight countries had relevant policies and programs to address child malnutrition and macronutrient deficiencies with targets for significant reductions in stunting and improved breastfeeding. However, despite the outlined there are major challenges of implementation, monitoring, evaluation and quality that persist with increased dependency on international donors and organisations for funding and/or implementation of nutrition plans.

CONCLUSION

There is a need to contextualise efforts designated to donors and governments to improve the tracking of efforts that impact nutrition.

Effective and Scalable Interventions to Reduce Sodium Intake: a Systematic Review and Meta-Analysis

PURPOSE OF REVIEW

High-sodium intake is a main risk factor for increased blood pressure and cardiovascular disease, the leading cause of death worldwide. Reducing sodium intake at the population level is one of the most cost-effective strategies to address this. The aim of the present systematic review and meta-analysis are to examine data from recent studies that measure the effectiveness and scalability of interventions aimed at reducing sodium intake at both the population and individual level.

RECENT FINDINGS

Worldwide, sodium intake is higher than the World Health Organization recommendations. Structural interventions such as mandatory reformulation of foods, food labeling, taxes or subsidies, and communication campaigns have shown to be the most effective in reducing the population's sodium consumption. Interventions in education, particularly those that use a social marketing framework with short duration, food reformulation, and combined strategies, have the potential to decrease sodium intake.

Prostitutes, sailors and professionals - lived experiences of medical school students and staff with tattoos

Background: The aim of this study was to explore the lived experiences of medical school students and staff to uncover gaps in policy and its effects on those with tattoos. Methods: Adopting a phenomenological design, semi-structured interviews were conducted with ten medical teaching staff and students who had tattoos, within one university medical school. Five key themes emerged: tattoo motives, tattoo content, positive and negative views on tattoos and challenges for establishing policy. Results: Findings suggested that no existing stigma towards staff or students exists, however, there is an absence in existing policy regarding tattoos. Participants' motivations for obtaining tattoos mirrored those of the public, most commonly being artistic expression. Images of tattoos related to nature were common. Views on tattoos suggested the need for a full reform of 'dress code' policy for the profession. Several ethically laden scenarios were espoused, highlighting the need for an official stance on tattoos. Policy discussions flagged challenges for those who construct such documents; cultural and generational differences being commonly identified by participants. Conclusions: Universally there was uncertainty on current policy, with no individual able to recount specific guidance. The existence of a hidden curriculum surrounding tattoos within medical school further increases the need for guidance reform.

On the frontiers of Twitter data and sentiment analysis in election prediction: a review

Election prediction using sentiment analysis is a rapidly growing field that utilizes natural language processing and machine learning techniques to predict the outcome of political elections by analyzing the sentiment of online conversations and news articles. Sentiment analysis, or opinion mining, involves using text analysis to identify and extract subjective information from text data sources. In the context of election prediction, sentiment analysis can be used to gauge public opinion and predict the likely winner of an election. Significant progress has been made in election prediction in the last two decades. Yet, it becomes easier to have its comprehensive view if it has been appropriately classified approach-wise, citation-wise, and technology-wise. The main objective of this article is to examine and consolidate the progress made in research about election prediction using Twitter data. The aim is to provide a comprehensive overview of the current state-of-the-art practices in this field while identifying potential avenues for further research and exploration.

Resilience, endogenous policy responses to COVID-19, and their impacts on farm performance

Policy measures aimed at containing the spread of the COVID-19 pandemic had unintended consequences on economic activities globally. In this study, we isolate and investigate the short-term partial impacts of six such measures on the farm and nonfarm incomes of agricultural households and examine the related resilience factors. Using Nigeria as a case study, we find that the COVID containment measures had mixed effects on farm and non-farm incomes in the short run. These varying effects are due to households' resilience and vulnerability factors, including land size, wealth, income diversification, involvement in processing activities, and reliance on hired labor. Our findings highlight the need for more targeted health crisis containment measures which consider the uniqueness, diversity, and regional heterogeneity of agriculture, especially the potential implications for farm viability.

Sustainability energy security: 20 years assessment of the West African Nations using a comprehensive entropy-TOPSIS analysis

Energy security in Africa has become a crucial issue in recent times due to the imminent lack of access to electricity, increasing energy demand informed by economic growth, population growth, and forecasts that point to business as usual on the continent based on these variables. While the West African region has abundant energy resources, they have not yet been translated into sustainable energy security, as it pertains to energy availability. This is a persistent challenge that needs to be addressed to support economic growth and social development in the region. Therefore, this study aims to assess the sustainable energy security in five West African countries (Nigeria, Senegal, Ghana, Cote d'Ivoire, and Togo), using nine energy security indicators and taking into cognizance, the energy, economic, social, and environmental security dimensions. The entropy-TOPSIS methodology of multi-criteria decision-making (MCDM) is used in estimating the energy security index across 20 years (2000-2019). The result showed that the situation in Cote d'Ivoire is reported to be "safe" in terms of sustainable energy security. It is reported that in Togo, energy security is at a "dangerous" level, which is ultimately tied to the low energy, economic, and societal security in the country. The findings of this study could be valuable for policymakers working on energy and climate policy at the national and regional levels. Based on the results, it may be necessary to take stronger legal action to ensure the implementation of energy security goals in the West African countries, which have struggled to meet their targets and have faced challenges in implementing policies at the desired pace.

Provincial policies affecting resident quality of life in Canadian residential long-term care

BACKGROUND

The precautions and restrictions imposed by the recent Covid-19 pandemic drew attention to the criticality of quality of care in long-term care facilities internationally, and in Canada. They also underscored the importance of residents' quality of life. In deference to the risk mitigation measures in Canadian long-term care settings during Covid-19, some person-centred, quality of life policies were paused, unused, or under-utilised. This study aimed to interrogate these existing but latent policies, to capture their potentiality in terms of positively influencing the quality of life of residents in long-term care in Canada.

METHODS

The study analysed policies related to quality of life of long-term care residents in four Canadian provinces (British Columbia, Alberta, Ontario, and Nova Scotia). Three policy orientations were framed utilising a comparative approach: situational (environmental conditions), structural (organisational content), and temporal (developmental trajectories). 84 long term care policies were reviewed, relating to different policy jurisdictions, policy types, and quality of life domains.

RESULTS

Overall, the intersection of jurisdiction, policy types, and quality of life domains confirms that some policies, particularly safety, security and order, may be prioritised in different types of policy documents, and over other quality of life domains. Alternatively, the presence of a resident focused quality of life in many policies affirms the cultural shift towards greater person-centredness. These findings are both explicit and implicit, and mediated through the expression of individual policy excerpts.

CONCLUSION

The analysis provides substantive evidence of three key policy levers: situations-providing specific examples of resident focused quality of life policy overshadowing in each jurisdiction; structures-identifying which types of policy and quality of life expressions are more vulnerable to dominance by others; and trajectories-confirming the cultural shift towards more person-centredness in Canadian long-term care related policies over time. It also demonstrates and contextualises examples of policy slippage, differential policy weights, and cultural shifts across existing policies. When applied within a resident focused, quality of life lens, these policies can be leveraged to improve extant resource utilisation. Consequently, the study provides a timely, positive, forward-facing roadmap upon which to enhance and build policies that capitalise and enable person-centredness in the provision of long-term care in Canada.

Development and environmental policies of Ethiopia: Policy review from view point of development-environment sustainability linkage

Ethiopia is rich in a wide range of agro-ecological zones in which a variety of agricultural activities and farming systems operate. These agricultural activities and farming systems affect the quality of the environment and sustainability of natural resources in different ways, which should be one of the prime concerns of national development policies. The objective of this study was to determine the extent to which Ethiopia's national development, environmental policies, and strategic plans consider the interrelationship between farming systems and environmental sustainability. The second objective was to determine the extent to which the policies and strategies integrate economic growth and environmental sustainability. Accordingly, different national development policies, strategies, and programs of Ethiopia were reviewed. The results reveal that these policies and strategies fundamentally focus on economic growth. Policymakers did not pay adequate attention to the environmental effects of farming systems in national development policies and strategic plans. Policies do not consider the integration of development and environmental sustainability. Simply put, the multidimensional links between economic growth and environmental sustainability have not been adequately articulated in development policies and programs. Therefore, both economic and environmental effects of the farming systems should be well-addressed during the preparation of development policies and strategic plans.

World Health Organization survey on the level of integration of traditional Chinese medicine in Chinese health system rehabilitation services

Background

To meet the growing global demand for rehabilitation services, the World Health Organization (WHO) launched Rehabilitation 2030. This study was commissioned by the WHO to investigate the integration degree of traditional Chinese medicine (TCM) in Chinese health system rehabilitation services and the demand for TCM rehabilitation in China.

Methods

Twenty TCM rehabilitation experts and relevant government administrators were invited to complete the questionnaire between September 2019 and January 2022. The development of traditional, complementary, and integrative medicine (TCI) rehabilitation in China was assessed primarily based on six different health system components.

Results

26 policies, regulations, and national strategic plans related to TCI rehabilitation were issued by relevant government departments since 2002; notably, 14 policies related to TCI rehabilitation development were intensively introduced from 2016 to 2021. These policies cover the three main areas of financing, infrastructure development, and service delivery. The National Administration of Traditional Chinese Medicine's investment in TCM clinical capacity infrastructure and scientific research in 2019-2021 increased by 66% compared to 2010-2012, and the average number of TCM hospitals with rehabilitation departments in 2020 increased by 6.5% compared to 2018. The proportion of community health service centers providing TCM services in primary medical and health institutions has increased by 30.8% over the past 10 years.

Conclusion

Long-term continuous policies, substantial financial investment, and expansion of the scope of TCI rehabilitation services in primary care institutions have effectively contributed to the rapid development of TCI rehabilitation. However, human resources and financing mechanisms for TCI rehabilitation need further improvement.

A comprehensive review of the production, adoption and sustained use of biomass pellets in Ghana

Ghana's Renewable Energy Master Plan of 2019 includes the production and use of biomass pellets. However, pellets have neither been developed commercially nor included in Ghana's energy mix. This paper reviewed the prospect of production, adoption and sustained use of pellets in Ghana. Besides having abundant biomass resources, Ghana has high market demand and relevant policies for pellet development. The production of pellets can significantly replace traditional household biomass demand and improve environmental and health quality. However, the production and use of pellets are limited due to technical, financial, social and policy issues. Our estimates show that 3% of the annual national average household income will be spent on pellet demand for cooking, with the highest burden on rural households in Ghana. Practical measures are required since the cost of pellets and gasifier stoves may limit pellet adoption and use in Ghana. Based on study findings, it is recommended that the government of Ghana establishes a robust supply chain and provides infrastructure for pellet production and use. Existing renewable energy policies should be reviewed to remove ambiguities, attract investment, and build capacity in the renewable energy sector. Apart from raising public awareness of the benefits of pellets use, the government of Ghana should ensure that continuous and thorough impact assessments are undertaken to assess the implications of pellet production and use. This review will inform policymaking on achieving sustainable production, adoption and use of pellets and assess Ghana's contribution to achieving the United Nations' sustainable development goals.

Midterm Maelstrom: Public Health Legal Impacts of Election 2022

Among the morass of critical issues impacting the results of the midterm elections in 2022 were core public health issues related to health care access, justice, and reforms. Collectively, voters' communal health and safety concerns dominated outcomes in key races which may shape national, state, and local legal approaches to protecting the public's health in the modern era.

A survey of experts on personalized medicine landscape in European Union and China

INTRODUCTION

Personalized Medicine (PM) is one of the main priorities of the research agenda of the European Commission and the focus of the European Coordination and Support Action titled "Integrating China into the International Consortium for Personalized Medicine" (IC2PerMed). Similar to the European focus, PM is a current priority of the Chinese Government, through dedicated policies and its five-year investment plans. In the context of IC2PerMed, we implemented a survey to understand the state of the art of the implementation of PM related policies in EU and China, and to identify opportunities for future Sino-European collaborations.

METHODS

The survey was elaborated by the IC2PerMed consortium and validated by a focus group of experts. The final version, in English and Chinese, was administered online to a pool of accurately selected experts. Participation was anonymous and voluntary. The survey consists of 19 questions in 3 sections: (1) personal information; (2) policy in PM; (3) facilitating and hindering factors for Sino-European collaboration in PM.

RESULTS

Forty-seven experts completed the survey, 27 from Europe and 20 from China. Only four participants were aware of the implementation of PM-related policies in their working country. Expert reported that PM areas with greatest policy impact so far were: Big Data and digital solutions; citizen and patient literacy; and translational research. The main obstacles found were the lack of shared investment strategies and the limited application of scientific developments in clinical practice. Aligning European and Chinese efforts, finding common ground across cultural, social, and language barriers, were considered as actions needed to enhance efforts in applying PM strategies internationally.

CONCLUSION

To achieve efficiency and sustainability of health systems, it remains crucial to transform PM into an opportunity for all citizens and patients with the commitment of all the stakeholders involved. The results obtained aim to help define common research and development approaches, standards and priorities and increase collaboration at international level, as well as provide key solutions to enable convergence towards a common PM research, innovation, development and implementation approach between Europe and China.

COVID-19 and Protracted Displacement: a Scoping Review of Migration Policies in Mexico and Central America

By the end of 2020, more than 500,000 migrants from Central America, Haiti, Africa, and Asia sought asylum along the US-Mexico border despite COVID-19-related travel restrictions and public health measures. A scoping review was conducted to understand the role of COVID-19-related policies on irregular migration flows through Central America and Mexico and to examine the experiences of asylum seekers traversing this region. Peer-reviewed literature, policy briefs, and commentaries were screened for inclusion, resulting in 33 documents selected for this review. This review identified three dominant themes: border closures due to multiple national migration policies, delays in asylum procedures, and increased risks to migrant wellbeing. This article argues that border closures were a punitive policy measure to deter irregular migration during the COVID-19 pandemic. Implications for future research and policy include prioritizing the health needs of asylum seekers and advocating the appropriateness and effectiveness of immigration and public health policy.

From old pollutants to the regulation of bisphenol A: Lessons learned for health promotion and disease prevention

Citizens deserve regulatory changes and policies more sensitive to the current needs of humans, the climate, and nature. In this work we draw on prior experiences of preventable human suffering and economic losses caused by delayed regulation of legacy and emerging pollutants. Heightened awareness of environmental health problems is necessary among health professionals, the media, and citizens' organizations. Improved translation from research to the clinical world and to policy is critical to reduce the population burden of diseases caused by exposure to endocrine disruptors and other environmental chemicals. Numerous lessons can be learned from science-to-policy processes built for "old pollutants" (as persistent organic pollutants, heavy metals, tributyltin), as well as from current trends regarding the regulation of non-persistent chemicals, such as the prototypical endocrine disruptor bisphenol A. We end discussing relevant pieces of the puzzle to tackle the environmental and regulatory challenges faced by our societies.

Child Maltreatment During COVID-19: Key Conclusions and Future Directions Based on a Systematic Literature Review

The COVID-19 pandemic has had a far-ranging impact. As societies struggled to minimize infection, questions arose regarding the consequences for children. Initial research reported the urgent need for child protective services worldwide to adapt existing policies and practices to protect children from maltreatment during this time, which is the rationale for the current systematic literature review. This review examined studies published in peer-reviewed journals from March 2020 to October 2020 on child maltreatment (CM) in the context of COVID-19. Twenty-five manuscripts met the inclusion criteria and were predominantly from the United States, with three international studies. The majority of the studies included CM reports during COVID-19 based on official data. The results clearly demonstrated an increased risk for children alongside a worrisome international decrease in CM reports. Only two studies addressed interventions during the pandemic. The current review highlights that, along with the obligation of scholars to advance the protection of children during COVID-19, there is much that is unknown. Future studies should examine the impact of the pandemic on children and their surrounding systems as well as child protective services' responses, which face enormous challenges during a pandemic. An additional conclusion is that, since children were not identified as a health risk group during the pandemic, their protection rights may have been jeopardized. Furthermore, the variance identified in the policies of different countries pinpoints the urgent need to establish an international protocol for protecting children from maltreatment during COVID-19, a protocol that will hopefully be a basis for policymakers worldwide.

COVID-19 in the homeless population: a scoping review and meta-analysis examining differences in prevalence, presentation, vaccine hesitancy and government response in the first year of the pandemic

AIMS

People experiencing homelessness (PEH) have been identified as being increasingly susceptible to Coronavirus disease (COVID-19), with policies enacted to test, isolate, increase hygiene practices and prioritise vaccines among this population. Here, we conduct a scoping review of the current evidence-base pertaining to the prevalence and presentation of COVID-19 in PEH, COVID-vaccine hesitancy rates and government interventions enacted within the first year of the pandemic for PEH.

MATERIALS AND METHODS

A systematic search was conducted on Pubmed, Cochrane, Embase and MedRxiv databases for studies reporting primary data on COVID-19 prevalence and clinical characteristics in PEH, vaccine uptake for PEH and policies enacted targeting PEH. Study qualities were assessed with The National Heart, Lung and Blood Institute's set of Study Quality.

RESULTS

Eighty-three studies were included in our final analysis. The overall prevalence of symptomatic COVID-19 infection in PEH is estimated at 35%. The most common symptoms found were cough and shortness of breath, followed by fever. Concerns regarding vaccine hesitancy amongst PEH related to thoroughness of COVID-19 vaccine clinical trials, side effects and mistrust of the government. The main strategies implemented by governments were mass testing, adaption of healthcare service provision, provision of alternative housing, encouraging personal hygiene (hand sanitation and mask wearing), and inter-organisational communication.

DISCUSSION

In our meta-analysis, 35% of PEH with a COVID-19 infection presented symptomatically; the low prevalence of symptomatic COVID-19 infection suggests widespread testing following outbreaks would be beneficial for this group of individuals. Temporary recuperation units and measures for housing stability in the pandemic, namely provision of alternative housing and stopping evictions, were found to be highly effective. High rates of vaccine hesitancy means that education and encouragement towards vaccination would be beneficial for this vulnerable population, where comorbidities are common. Finally increased focus in research should be placed on the mental health burden of COVID-19 and the pandemic on PEH moving forwards.

On integrating patient appointment grids and technologist schedules in a radiology center

Optimal patient appointment grid scheduling improves medical center performance and reduces pressure from excess demand. Appointment scheduling efficiency depends on resource management, and staff are a key resource. Personnel scheduling takes into account union rules, skills, contract types, training, leave, illness, etc. When combined with appointment scheduling constraints, the complexity of the problem increases. In this paper, we study the combination of the patient appointment grid and technologist scheduling. We present a well-detailed framework outlining our approach. We develop two versions of a mixed-integer programming model: integrated and sequential. In the first version, we elaborate the appointment grid and the technologist schedules simultaneously, while in the second version we generate them sequentially. We evaluate the proposed approach using real data from the MRI department of the Centre hospitalier de l'Université de Montréal (CHUM) radiology center. We study different scenarios by testing several technologist rules and planning construction methods. Obtained solutions are compared to the current CHUM scheduling approach.

From pressure in the pipeline to accelerating ascension: a survey to understand professional experiences of and opportunities for Canadian women in the healthcare sector

BACKGROUND

Much has been written about the state and persistent lack of progress regarding gender equity and the commonly referenced phenomenon of a 'leaking pipeline'. This framing focuses attention on the symptom of women leaving the workforce, rather than the well-documented contributing factors of hindered recognition, advancement, and financial opportunities. While attention shifts to identifying strategies and practices to address gender inequities, there is limited insight into the professional experiences of Canadian women, specifically in the female-dominated healthcare sector.

METHODS

We conducted a survey of 420 women working across a range of roles within healthcare. Frequencies and descriptive statistics were calculated for each measure as appropriate. For each respondent, two composite Unconscious Bias (UCB) scores were created using a meaningful grouping approach.

RESULTS

Our survey results highlight three key areas of focus to move from knowledge to action, including (1) identifying the resources, structural factors, and professional network elements that will enable a collective shift towards gender equity; (2) providing women with access to formal and informal opportunities to develop the strategic relational skills required for advancement; and (3) restructuring social environments to be more inclusive. Specifically, women identified that self-advocacy, confidence building, and negotiation skills were most important to support development and leadership advancement.

CONCLUSIONS

These insights provide systems and organizations with practical actions they can take to support women in the health workforce amid a time of considerable workforce pressure.

Firm behavior during an epidemic

We derive a model in which firms operate in an epidemic environment and internalize infections among their employees in the workplace. The model is calibrated to fit the moments of the Covid-19 epidemic. We show that firms have incentives to fight against infections and can do so very effectively by increasing teleworking and rotating employees between on-site work, teleworking, and leave. The fight against infections in firms flattens the aggregate infections curve. Subsidies to teleworking reduce infections and save lives. Subsidies to sick leave reduce the cost of sick workers and raise workplace infections. Firms delay and weaken the fight against infections during economic downturns. We also consider the problem of a government that values output and lives. We show that the government prefers to severely restrict the epidemic by tolerating short-term output losses when it has a high valuation of life.

Free satellite image data application for monitoring land use cover changes in the kon ha nung plateau, vietnam

Remote sensing imagery is the most suitable tool for monitoring, managing, and evaluating land-use overlay fluctuations, especially forest cover for large areas. Free- and medium-resolution satellite imagery is a useful tool that allows scientific researchers and management organizations to monitor forest development in developing countries, such as Vietnam. In this study, we used SPOT 4 and Planet remote sensing data to assess land-use status fluctuations in the Kon Ha Nung Plateau area, Vietnam, between 2000 and 2021 (the overall accuracy was 90.52%, Kappa value = 0.89). The results showed that from 2000 to 2010, the rate of natural forest loss in this area was 0.32%/year, of which, more than 6500 ha were converted to other uses. Between 2010 and 2021, the rate of natural forest loss gradually decreased (0.09%/year) instead of fluctuating between different types of land use. The area of forests, perennial crop land, and annual crop land tended to increase from 2000 to 2010; however, from 2010 to 2021, the area of plantation forests decreased markedly, while the area of perennial crop land and annual crop land continued to expand. The analysis of the policies on forest management, exploitation, and protection was applied locally, to explain the causes of the change in spatiotemporal aspects of the types of land-use cover in the Kon Ha Nung Plateau. Restoring forest areas during 2010-2021 initially improved effectiveness in forest management and protection. Furthermore, the results provide a better understanding of the current position and role of the government apparatus, cadres, and ethnic minorities in socioeconomic development associated with forest protection and development on the Kon Ha Nung Plateau. The results of this study can help managers monitor annual forest-cover fluctuations based on free remote sensing imagery to reduce both the cost of management and surveying, yielding relatively accurate results.

Inclusion of diabetic retinopathy screening strategies in national-level diabetes care planning in low- and middle-income countries: a scoping review

BACKGROUND

Diabetes is a major public health concern, with approximately 80% of the burden falling on low- and middle-income countries (LMICs). Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes, and early detection through diabetic eye screening programmes is essential to prevent visual impairment and blindness. Careful planning at a national level is crucial for effective implementation of such programmes.

METHODS

A scoping review was conducted, and the protocol was published previously to explain the methods in detail. Data were collected from databases and searches, including grey literature. Furthermore, consultations were conducted with key informants from LMICs.

RESULTS

Lower-middle-income countries (29/50, 58%) and upper-middle-income countries (27/59, 45.8%) are making more progress than low-income countries (4/29, 13.8%) in terms of DR policy planning. However, no identified data for published policies have actually implemented national DR policies. Compared to low-income and lower-middle-income countries, upper-middle-income countries are making the most progress in implementing national diabetic eye screening programmes; however, their progress is still slow, with only 5/59 (8.5%) having such programmes.

CONCLUSION

There are significant gaps in the literature, with no data reported for 78/138 (56.5%) LMICs. Further research is clearly needed to support and document DR policy development in LMICs.

Policy-Based Holistic Application Management with BPMN and TOSCA

With the wide adoption of cloud computing across technology industries and research institutions, an ever-growing interest in cloud orchestration frameworks has emerged over the past few years. These orchestration frameworks enable the automated provisioning and decommissioning of cloud applications in a timely and efficient manner, but they offer limited or no support for application management. While management functionalities, such as configuring, monitoring and scaling single components, can be directly covered by cloud providers and configuration management tools, holistic management features, such as backing up, testing and updating multiple components, cannot be automated using these approaches. In this paper, we propose a concept to automatically generate executable holistic management workflows based on the TOSCA standard. The practical feasibility of the approach is validated through a prototype implementation and a case study.

International crew changes amid global pandemic outbreaks: Key issues and system innovations

The outbreak of COVID-19 pandemic all over the world has seriously affected seafarers' work and life. In this paper, we focus on the countermeasures of major countries and organizations on the seafarer shift matter during the pandemic period. And the target of this paper is to become useful in promoting the shift change of seafarers more smoothly. Policies are identified on the basis of a systematic review of importance in combination with a detailed analysis of the primary global and national policy initiatives. Findings suggest that the root cause of the international crew change crisis lies in the issues and deficiencies in the crew change system, economic security, seafarers' welfare, and seafarers' social security among other aspects. On this basis, this paper gives feasible suggestions in the respects of system innovation, economic security and welfare, social security system innovation and technical innovation.

How to Evaluate Health in All Policies at the Local Level: Methodological Insights Within Municipalities From the WHO French Healthy Cities Network

BACKGROUND

This article proposes a method for analysing the degree of maturity of Health in All Policies (HiAP) among World Health Organization-French Healthy Cities Network (WHO-FHCN) as part of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project. We focused on the creation or enhancement of health-promoting environments, and more specifically, public green spaces.

METHODS

We conducted a cross-sectional quantitative study guided by the evaluative framework of the HiAP maturity level developed by Storm et al mixed with a qualitative interpretation. A self-administered questionnaire was sent to elected officials and health department officers in the 85 member cities of the WHO-FHCN in 2017. Subsequently 58 cities were included in the analysis, which was based on a multiple correspondence analysis (MCA) and a hierarchical ascending classification (HAC).

RESULTS

Thirty-two criteria among a total of 100 were identified and were used to organize the cities into 8 groups which was then reduced to three profiles among the cities: a less advanced HiAP profile, an established HiAP profile and an advanced HiAP profile. This process allows us to identify 4 dimensions that make it possible to evaluate the level of maturity of cities in the HiAP process, namely: (1) the consideration of social inequalities in health and/or health issues in the policies/actions of the sector studied, (2) occasional intersectoral collaboration, ie, one-off initiatives between the health department and others sectors, (3) the existence of joint projects, ie, common projects between two or more sectors, (4) the existence of intersectoral bodies, in this case on the theme of urban green spaces including an intersectoral committee and/or working groups.

CONCLUSION

Four dimensions which allow to the measurement of the degree of progress in implementing health-all-policies are proposed. With a view to integrating knowledge into public action, this study carried out under real conditions offers a realistic method to evaluate HiAP.

Factors associated with smokefree rules in the homes of Black/African American women smokers residing in low-resource rural communities

Little is known about the implementation of voluntary policies in the homes of Black/African American women smokers who live in rural areas where health care access is limited. This paper examines 1) the sample's prevalence of comprehensive smoke-free rules; 2) sociodemographic, social, and smoking characteristics of women by home rule type; and 3) the association of social indicators with the outcome complete ban on smoked tobacco use in the home (n = 191). Families Rising to Enforce Smokefree Homes collected baseline data from 2019 to 2021 prior to randomization to an intervention that aimed to increase comprehensive smokefree policies in the homes African American women living in the rural Delta region of Arkansas. The primary outcome was implementation of a complete ban on all smoked tobacco products anywhere inside the home. Results showed that 26% of women had a rule that completely banned all smoked tobacco products in the home. Women who reported having no ban were more likely to be employed part-time (50.0%), while women with a partial (66.9%) or complete ban (60.0%) were more likely to not currently work for pay. Women who indicated that they just meet basic expenses and meet needs with little left had significantly lower odds of having a complete ban on smoked tobacco in the home than women who indicated that they live comfortably. Perceived financial security may be a motivating factor that helps women keep their homes free from all smoked tobacco products (# NCT03476837).

Content and strength of conflict of interest policies at Scandinavian medical schools: a cross sectional study

BACKGROUND

Concerns around staffs' and students' interactions with commercial entities, for example drug companies, have led several North American medical schools to implement conflict of interest (COI) policies. However, little is known about COI policies at European medical schools. We analysed the content and strength of COI policies at Scandinavian medical schools.

METHODS

We searched the websites of medical schools in Denmark, Norway, and Sweden and emailed the Deans for additional information. Using comparable methodology to previous studies, the strength of the COI policies was rated on a scale from 0 to 2 across 11 items (higher score more restrictive); we also assessed the presence of oversight mechanisms and sanctions.

RESULTS

We identified 77 unique policies for 15 medical schools (range 2-8 per school). Most of the policies (n = 72; 94%) were University wide and only five (6%) were specific for the medical schools. For six of eleven items one or more schools had a restrictive policy (score of two). None of the schools had a restrictive policy for the five additional items (speaking relationships, sales representatives, on-site education activities, medical school curriculum, and drug samples). Honoraria was the item with the highest score, with eight of the 15 schools having a score of two. Thirteen of the 15 schools had policies that identified a party responsible for policy oversight and mentioned sanctions for non-compliance.

CONCLUSION

Our study provides the first evaluation of all Scandinavian medical schools' COI policies. We found that the content of COI policies varies widely and still has shortcomings. We encourage Scandinavian medical schools to develop more stringent COI policies to regulate industry interactions with both faculty and students.

Current status of Approaches of Universities in Fostering Research Ethics in Thailand

Research ethics and integrity are essential topics that researchers should always be concerned about and are emphasized by academic communities around the world. However, there is currently little information or any comprehensive study on the mechanisms to regulate research ethics and integrity in Thailand. Therefore, the aims of this study were to determine the approaches that universities used to support research ethics and integrity in Thailand and also to identify the barriers that may obstruct the development. A questionnaire was used to explore the strategies about research ethics of 44 Thai universities. It was found that the first three mechanisms used to foster research ethics and integrity were establishment of institutional regulatory research committees (84%), conduction of research ethics training programs (77%), and policy adoption (68%). Interestingly, there was a significant association between the sizes of universities and establishment of institutional regulatory research committees. The medium and small universities might need more help and support to develop their own research ethics regulatory mechanisms. The results here indicated good signs for Thailand about preparing basic structures for fostering research ethics and integrity. The recognition of this current status could provide the useful information for future development of research integrity in Thailand.

Current Status of Ponds in India: A Framework for Restoration, Policies and Circular Economy

Healthy pond ecosystems are critical for achieving several sustainable development goals (SDG) through numerous ecosystem services (e.g., flood control, nutrient retention, and carbon sequestration). However, the socio-economic and ecological value of ponds is often underestimated compared to the larger water bodies. Ponds are highly vulnerable to mounting land-use pressures (e.g., urban expansion, and agriculture intensification) and environmental changes, leading to degradation and loss of the pond ecosystem. The narrow utilitarian use-based conservation fails to recognize the multiple anthropogenic pressures and provides narrow solutions which are inefficient to regenerate the degraded pond ecosystem. In this paper, we holistically examined the legal challenges (policies) and key anthropogenic and environmental pressures responsible for pond degradation in India. The country is strongly dedicated to attaining SDG and circular economy (CE) through aquatic ecosystem conservation and restoration. Considerable efforts are required at the administration level to recognize the contribution of pond ecosystem services in attaining global environmental goals and targets. Worldwide restoration strategies were reviewed, and a framework for pond restoration and conservation was proposed, which includes policies and incentives, technologies such as environmental-DNA (e-DNA), life cycle assessment (LCA), and other ecohydrological measures. Nature-based solutions (NBS) offer a sustainable and cost-effective approach to restoring the pond's natural processes. Furthermore, linkage between the pond ecosystem and the CE was assessed to encourage a regenerative system for biodiversity conservation. This study informs the need for extensive actions and legislative reforms to restore and conserve the pond ecosystems.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13157-022-01624-9.

Ethical principles for artificial intelligence in education

The advancement of artificial intelligence in education (AIED) has the potential to transform the educational landscape and influence the role of all involved stakeholders. In recent years, the applications of AIED have been gradually adopted to progress our understanding of students' learning and enhance learning performance and experience. However, the adoption of AIED has led to increasing ethical risks and concerns regarding several aspects such as personal data and learner autonomy. Despite the recent announcement of guidelines for ethical and trustworthy AIED, the debate revolves around the key principles underpinning ethical AIED. This paper aims to explore whether there is a global consensus on ethical AIED by mapping and analyzing international organizations' current policies and guidelines. In this paper, we first introduce the opportunities offered by AI in education and potential ethical issues. Then, thematic analysis was conducted to conceptualize and establish a set of ethical principles by examining and synthesizing relevant ethical policies and guidelines for AIED. We discuss each principle and associated implications for relevant educational stakeholders, including students, teachers, technology developers, policymakers, and institutional decision-makers. The proposed set of ethical principles is expected to serve as a framework to inform and guide educational stakeholders in the development and deployment of ethical and trustworthy AIED as well as catalyze future development of related impact studies in the field.

Country immunization policies for refugees across 20 low-middle income and 20 high-income countries

In 2020, 26 million refugees resettled in a new country-fleeing their homes due to conflict and persecution. Due to low immunization coverage and underlying health conditions, refugees commonly face an increased risk of contracting vaccine-preventable diseases. We collected and analyzed existing routine immunization policies for refugees across 20 low- and middle-income countries (LMICs) and 20 high-income countries (HICs), each with the highest number of refugees per 1000 residents. Primary and secondary data sources were used to collect policy evidence. Across 20 LMICs, 13 countries specified standing nationwide routine immunization policies for refugees, while 14 out of the 20 HICs included refugees in their national routine immunization programs. LMICs and HICs should include refugees in their national routine immunization policies and provide accessible and affordable immunizations. Such efforts would reduce vaccine-preventable diseases and protect the health of refugee populations-especially during the COVID-19 pandemic.

Palm oil-based bioenergy sustainability and policy in Indonesia and Malaysia: A systematic review and future agendas

This paper reviews previous research on the sustainability and policies of palm oil-based bioenergy in Indonesia and Malaysia. A systematic literature review with a meta-analysis (PRISMA) methodology was performed to evaluate the related articles discussing sustainability and bioenergy policies. This study found 96 articles that mapped the sustainability and policies of bioenergy in Indonesia and Malaysia over the last decade. The sustainability studies were divided into two areas: the environment and socioeconomics. Researchers were more likely to examine environmental factors than socioeconomic factors, specifically focusing on the following environmental indicators: land use conversion, deforestation, and CO₂ emissions. Most policy studies concentrated on sustainability and energy security. Over the last two decades, the development of bioenergy policies in Indonesia and Malaysia has been comparable in terms of geographical position and palm oil production. However, Indonesia's bioenergy policy has tended to be more vigorous and dynamic than Malaysia.

A Qualitative Study on the Needs of Women with Metastatic Breast Cancer

Few studies have investigated the needs of patients with metastatic breast cancer (MBC), and none have been conducted in Italy. Three categories of needs have been identified from the literature: information, support, and practical resources. The present study aims to achieve an in-depth understanding of the patients' needs related to the MBC care pathway. In-depth interviews were conducted and analyzed by thematic analysis. The participants were 9 women with MBC (age range 36-74) who were enrolled at the Fondazione IRCCS Istituto Nazionalde dei tumori, in Milan. The analysis enabled us to identify four themes (which reflect the needs of the participants), each divided into numerous sub-themes: (1) the need for clinical recognition, (2) the need for more attention from healthcare professionals, (3) the need for more and better services to be available at the hospital, (4) the need for specific public health policies. Since the metastatic phase of breast cancer seems to elicit additional, specific needs and multi-level management, changes in attitudes and multidisciplinary practices should be tested in order to ascertain how these needs can be met.

Algal biorefinery culminating multiple value-added products: recent advances, emerging trends, opportunities, and challenges

Algal biorefinery is rising as a prominent solution to economically fulfill the escalating global requirement for nutrition, feed, fuel, and medicines. In recent years, scientific productiveness associated with microalgae-based studies has elaborated in multiplied aspects, while translation to the commercial level continues to be missing. The present microalgal biorefinery has a challenge in long-term viability due to escalated market price of algal-mediated biofuels and bioproducts. Advancements are required in a few aspects like improvement in algae processing, energy investment, and cost analysis of microalgae biorefinery. Therefore, it is essential to recognize the modern work by understanding the knowledge gaps and hotspots driving business scale up. The microalgae biorefinery integrated with energy-based products, bioactive and green compounds, focusing on a circular bioeconomy, is urgently needed. A detailed investigation of techno-economic analysis (TEA) and life cycle assessment (LCA) is important to increase the market value of algal products. This review discusses the valorization of algal biomass for the value-added application that holds a sustainable approach and cost-competitive algal biorefinery. The current industries, policies, technology transfer trends, challenges, and future economic outlook are discussed. This study is an overview through scientometric investigation attempt to describe the research development contributing to this rising field.

Minimizing COVID-19 Transmission Cases: Do Policies and Institutions Matter?

This paper examines the effects of institutional factors and government policy responses on COVID-19 infection cases. It applies the Random Effects (RE) and GMM (Generalized Method of Moments) estimation techniques to panel data to explore the relationship between COVID-19 cases on the one hand and institutions and government policy responses on the other. The paper finds that the nature and timing of policy responses matter and that institutions play a crucial role in explaining observed infection cases across countries. The results also indicate that high population density and previous experience with infectious diseases are important factors in explaining infection cases across countries. One of the policy implications of our findings is the importance of timely policy intervention at the national level in reducing infection cases.