An assessment of the owned canine and feline demographics in Chile: registration, sterilization, and unsupervised roaming indicators

The global rise in companion animal populations, particularly dogs and cats, is driven by emotional and social benefits for owners, and their population management is becoming critically important to avoid a plethora of adverse effects on themselves, humans, and wildlife. We estimated the size and density of the owned canine and feline population in Chile and evaluated the status of microchipping, registration, sterilization rates, and the proportion of owned animals that roam unsupervised. A cross-sectional household survey in 36 districts was conducted and standard inferential statistics was employed to analyze differences between cats and dogs, sexes within each species, and between rural and urban areas. Additionally, two negative binomial models with mixed effects were developed to predict the number of dogs and cats per households. Two methods were used to compare population size estimates at the country level, multiplying: (1) the estimated mean number of companion animals per household by the estimated number of households at the country level, and (2) the estimated human:dog and human:cat ratios by the total human population. The study involved 6333 respondents, of which 76% (74% urban; 83% rural) owned companion animals (dogs and/or cats). Individuals in rural multi-person households increase the probability of owning dogs and/or cats. Additionally, women exhibit a greater inclination towards cat and dog ownership compared to men, while those over 30 years old demonstrate lower rates of companion animal ownership in contrast to the 18-30 age group for both species. The overall human:dog and human:cat ratios estimated were 2.7:1, and 6.2:1, respectively. The estimated total number of owned dogs and cats in Chile ranged from 9.6 to 10.7 million, depending on the methodological approach, while national median density of companion animals was 12 dogs per km2 (ranging from 0.02 to 7232) and 5 cats per km2 (ranging from 0.01 to 3242). This nationwide study showed one of the highest percentages of households with companion animals in Latin America and relatively low registration and sterilization rates, highlighting the need to strength long-term public policies to control populations of companion animals and promote responsibility in pet ownership.

A comprehensive analysis of children's blood lead levels in Latin America and the Caribbean over the last eight years: Progress and recommendations

In 2017 we published a review on blood lead levels (BLL) in children from Latin America and the Caribbean (LAC) for data available up to 14th of March 2014 and recommended the identification and control of "lead hot spots". In the present study, an evaluation of progress toward reducing BLL in the region was carried out. A systematic review of the latest literature on lead exposure in the LAC region held on the PubMed, Web of Science and LILACS databases (January 2014 to March 2022) was conducted using the PRISMA methodology. Only original papers published in peer-reviewed English, Spanish, or Portuguese journals were eligible. A total of 558 papers were retrieved, 77 of which met the selection criteria and 31 (40.25 %) were carried out in Mexico. The prevalence of children with BLL above 10 μg. dL-1 was 22.08 % in the previous review versus 6.78 % in the current study. In the present review, the prevalence of children with BLL above 5 μg. dL-1 was 29.62 %, and only one study reported a BLL prevalence rate between 3.3 and 5 μg. dL-1. The highest BLLs were associated with well-known sources or occupational exposures. The number of countries (n = 13) that published data on BLL in children was lower compared to the previous review (n = 16). Most studies were conducted in areas with known lead exposure sources, similar to the earlier review. The percentage of children at risk of lead poisoning in the region remains unknown because few studies have published data on environmental exposure levels and most samples were relatively small. The recommendation to identify and control sources of lead exposure was maintained, while further suggestions for establishing a systematic public health surveillance system for lead were proposed to help reduce the knowledge gap and inform public health policy-making in LAC.

Air, land, and water pollutants and public health expenditures: Empirical data from selected EU countries in the transport sector

The increase in economic activity, particularly in transport, leads to a significant increase in emissions of pollutants, such as ammonia, arsenic and cadmium, at the European Union (EU) level. This can seriously impact human health and, consequently, public health spending. Based on data from 15 European Union countries from 1992 to 2020, a panel co-integration approach is used to study these pollutants' short- and long-term co-movements and per capita health expenditure. The results show a long-term relationship between ammonia, arsenic and cadmium emissions and per capita health spending, as they are panel-cointegrated. Ammonia and cadmium emissions exert a statistically significant positive effect on health expenditure in the short run, and arsenic emissions have a statistically significant positive impact in the long run. The forecast assessment of reductions in health spending resulting from policies to reduce emissions of air, land and water pollutants, such as ammonia, arsenic and cadmium, from the transport sector supports investments in its policies that reduce pressure on health spending. The reduction in annual healthcare expenditure is greater when these reductions are made sooner and more severely. Indeed, varying the reduction in emissions for each pollutant by 10% and 100%, respectively, from the first year for all countries over a 3-year period results in an average annual reduction in health spending of 2.05% and 51.02%, respectively. However, if we wait until the third year, the annual reduction is only 0.77% and 17.63% respectively.

Preparing schools for future pandemics: Insights on water, sanitation and hygiene solutions from the Brazilian school reopening policies

Post-COVID-19, schools urgently need to enhance infection control and prevention (IPC) measures, including water, sanitation, and hygiene (WASH), to prepare for future outbreaks and pandemics. Particularly in Brazil, that is of particular concern, as students are still recovering from the 20th longest school closure in the world. Hence, the current study had two goals: (i) to describe WASH solutions outlined in policies released at the federal, state, and capital city levels in Brazil during the COVID-19 pandemic for the safe reopening of schools and (ii) to discuss their potential to enhance school's capacity to remain operational during a new pandemic or outbreak. With a qualitative exploratory approach, we performed content analysis to discuss the direction (what, where, how and for whom?) of 66 public policies by integrating four frameworks. Solutions were discussed in the light of the principles of human rights and the human rights to water and sanitation, international guidelines for WASH and IPC in schools and the Sphere minimum standards for humanitarian aid. One hundred and fifty-nine solutions, spanning five thematic areas and five population groups, including software and hardware interventions, were compiled for potential use in Brazil and beyond. While suggested solutions have the potential to provide a cleaner and safer learning environment, it is essential to exercise caution when implementing these measures and adapt them to the specific circumstances of each school.

Simple economics of vaccination: public policies and incentives

This paper focuses on the economics of vaccination and, more specifically, analyzes the vaccination decision of individuals using a game-theoretic model combined with an epidemiological SIR model that reproduces the infection dynamics of a generic disease. We characterize the equilibrium individual vaccination rate, and we show that it is below the rate compatible with herd immunity due to the existence of externalities that individuals do not internalize when they decide on vaccination. In addition, we analyze three public policies consisting of informational campaigns to reduce the disutility of vaccination, monetary payments to vaccinated individuals and measures to increase the disutility of non-vaccination. If the public authority uses only one type of policy, herd immunity is not necessarily achieved unless monetary incentives are used. When the public authority is not limited to use only one policy, we find that the optimal public policy should consist only of informational campaigns if they are sufficiently effective, or a combination of informational campaigns and monetary incentives otherwise. Surprisingly, the requirement of vaccine passports or other restrictions on the non-vaccinated are not desirable.

Payment for Environmental Services: A critical review of schemes, concepts, and practice in Brazil

The Payment for Environmental Services (PES) is often conceived through complex schemes without a clear definition of all concepts involved. This study presents the results of a systematic literature review on PES schemes in Brazil, accompanied by a critical assessment of their efficacy for potential environmental gains. The PES approaches were grouped into six categories based on the research focus, and those that were focused on PES policies were identified as the most studied. A particular emphasis has been given to the Amazon and Atlantic Forest biomes, where the ecosystem services studied were mostly centered on issues related to carbon and water, respectively. Approximately one-third of all schemes provided no clear definition of which ecosystem services are proposed for payment. In addition, the review showed no consensus among studies on the definition of services in similar schemes. Most schemes presented no payment system conditioned on the provision of environmental services. Furthermore, the review showed that the absence of clarity in the application of concepts may hinder the development of public policies to properly implement PES in Brazil. The conclusion is that standardizing terms used in the literature and in PES schemes is critical; therefore, the use of the Common International Classification of Ecosystem Services (CICES) as a reference is recommended to ensure clarity, objectivity and, more importantly, the expected environmental efficacy.

Citizen scientists study beach litter along 12,000 km of the East Pacific coast: A baseline for the International Plastic Treaty

Anthropogenic Marine Litter (AML) accumulating on beaches causes damage to coastal ecosystems and high costs to local communities. Volunteers sampled AML on 130 beaches along the central and southern East Pacific coasts, with AML densities ranging from 0.46 to 2.26 items m-2 in the different countries. AML composition was dominated by plastics and cigarette butts, the latter especially in Mexico and Chile. The accumulation of AML in the upper zones of the beaches and substantial proportions of cigarette butts, glass and metal pointed mainly to local sources. Statistical modelling of litter sources on continental beaches revealed that tourism, access and related infrastructure (e.g. parking lots) best explained AML densities, while plastic densities were also influenced by the distance from river mouths and national Gross Domestic Product. Large-scale monitoring can be a useful tool to evaluate the effectiveness of public policies that should primarily focus on land sources.

Efficiency and productivity of the Chilean public health system between 2010 and 2019

Introduction

In view of the strong increase in health expenditure, it is necessary to investigate whether proportional increases in healthcare production for the beneficiaries of the National Health Fund have corresponded to this increase.

Methods

In this observational, descriptive, and retrospective longitudinal research, we estimate the technical efficiency of the National Health Services System through the average cost of production and average labor productivity in the period from 2010 to 2019.

Results

During the studied decade, production has increased by approximately 6% annually; the number of workers increased (mostly physicians) by 61%; spending on salaries increased by 106% in real terms; spending on consumer goods and services has increased by 25% in real terms; the efficiency of spending has decreased by 21%, and productivity is the least dynamic element of the system with an average annual growth rate of 0.6%. After subtracting the diagnostic tests component, this scenario worsens.

Conclusions

The results show that higher health expenditure has not been matched by commensurate increases in output, translating into a fall in the efficiency of healthcare expenditure and meager increases or falls in productivity, depending on how the output is measured. This means that the public sector's growth strategy depends mainly on increases in the number of workers. This low productivity is a serious constraint to improving healthcare access for National Health Fund beneficiaries and contributes to increasing waiting lists. Special attention should be paid to average production costs and average labor productivity in a scenario of less dynamic growth in public health spending and health system reform.

COVID-19 vaccination and governance in the case of low, middle and high-income countries

BACKGROUND

Global crises, regardless of the place where they started to spread or of the factors that triggered them, require a comprehensive approach, primarily based on good communication, cooperation and mutual support. No individual and no institution should remain indifferent to crises but, on the contrary, be fully aware that any involvement in curbing them matters. Although humanity can be affected by various types of crises, in this paper we refer to the one related to COVID-19 pandemic. There are certain reasons that come to justify our choice: first of all, being a shock with a strong impact on people, its analysis should be performed from several angles; this may bring to light an image with its disparate propagation and measures to counteract it both in developed countries, and especially in those with a shortage of resources. Secondly, in the context of the emergence of vaccines against COVID-19, it is helpful to have an overview of COVID-19 through the lens of the relationship between the vaccination process and the elements that characterize governance, with a differentiated dashboard by country categories worldwide: low, middle and high-income countries. Our study is far from capturing the complexity arising from such social problem, but rather aims to outline the defining role of governance when it comes to providing firm reactions to the COVID-19 crisis.

METHODS

Given that our sample consists of a large number of countries, namely 170, first, examined all together, and then, split into three groups (high, middle and low-income), it is challenging to address governance in association with COVID-19 vaccination, in order to see how much they interact and how each of the six aggregate governance indicators of the World Bank (Worldwide Governance Indicators) is reflected in this process. Even if they do not oscillate strongly over relatively short periods of time, reporting on health issues requires a sequential inventory, considering closer time intervals, so as to be able to act promptly. Thus, to better distinguish how the COVID-19 vaccination process evolved in low, middle and high-income countries, but also how it was imprinted by governance, we present the situation quarterly (March, June, September and December), in 2021, the year when the immunization campaigns were the most intense at the global level. Regarding the applied methods, we mention both OLS regressions with robust estimators and a panel model, used to investigate the determinants of COVID-19 vaccination, some of them describing the good governance, as well as other dimensions.

RESULTS

The findings point out that the influence of governance on COVID-19 vaccination differs depending on whether a country belongs to high, middle or low-income typology: the strongest determinism of governance on vaccination is encountered in high-income countries, and the weakest in low-income ones; in some cases, governance does not matter significantly. However, exploring the three groups of states included in the research, it is observed that the most relevant factors in this relationship are government effectiveness, regulatory quality and control of corruption.

CONCLUSIONS

Besides the order of importance of governance indicators on COVID-19 vaccination, our study indicates that, overall, governance positively shapes the vaccination rate at the level of the chosen sample. In normative terms, these findings can be translated particularly by the fact that they can serve as information to raise awareness on the relevance of the existence of an institutional framework that allows the formulation of strategies according to the patterns of each country, especially since the actionable tools depend on the available resources. As a general conclusion, public policies should be designed in such a way as to strengthen trust in vaccination regulations and in governments, to reduce the multifaceted negative effects of this health crisis and to hope for its total end.

Soil potentially toxic element contents in an area under different land uses in the Brazilian Amazon

Soil pollution with potentially toxic elements (PTE) from incipient basic sanitation, dumps and industrial activities developed in the Amazon has been of international interest due to health and environmental issues. This study aimed to evaluate the concentration of PTE in five adjacent land occupations (a dump, a alumina refinery area and three residential centers) in the municipality of Barcarena, Amazon Region, Brazil. In a total area of 912 ha, 274 soil samples were collected at a depth of 0-0.2 m. Afterwards, the concentrations of As, Ba, Pb, Co, Cu, Cr, Hg, Ni and Zn were determined. The results were explored using descriptive and multivariate statistics, as well as geostatistical. Considering the data by location, maximum concentrations exceeding the prevention values of Brazilian soils were found for Cu, Ni and Zn in Dump (148; 42.8 and 356 mg kg^-1), for Cu and Hg in Bom Futuro (333 and 1.99 mg kg^-1) and for Cu in Itupanema (91.2 mg kg^-1). Cu, Hg, Pb and Zn were grouped in the same principal component and showed the highest similarity measure in the cluster analysis. The interpolation point maps of the two principal components and of the individual concentrations of the PTEs showed the area of influence of the dump as the main reason for the increase in soil contamination. These results show the need for public policies aimed at the proper disposal of solid waste, in order to promote the reduction of pollutants in the soil, health and well-being for the local population, and also the environmental quality of the study area.

Evolution of nutritional status and associated factors among formula-fed infants with cow's milk protein allergy in a government program

BACKGROUND

Cow's milk protein allergy (CMPA) is a common allergy in infants and can affect proper growth and development. This study verified factors associated with the evolution of the nutritional status (NS) among infants with CMPA fed with hypoallergenic formulas (HF).

METHODS

This is a longitudinal study of infants (n = 1036) participating on a governmental program in Brazil. Researchers assessed Nutritional status before HF treatment (T1) and after HF treatment (T2). The causality of exposure variables on the evolution of NS was verified by Multinomial Logistic Regression (MLR).

RESULTS

We observed an increase in anthropometric indexes analyzed with statistically significant results (p < 0.01). The weight/age and height/age scores showed a significant reduction in infants with nutritional deficit. The Body Mass Index (BMI) showed a decrease in the number of infants with nutritional deficit (< -2 z-score). On the other hand, there was an increase in those classified as at risk of overweight, overweight and obese. MLR showed that those who remained < 12 months in the program had a lower odds ratio (95% CI = 0.355-0.906; p = 0.018) to have inadequate NS with increasing BMI. Preterm infants were 4 times more likely (CI 95% = 1.520-10.694; p = 0.005) to have their BMI decreased and those who received nutritional counseling had a lower odds ratio (CI 95% = 0.411-0.953; p = 0.029) to maintain adequate NS.

CONCLUSION

The program has a significant impact on the NS of infants with CMPA. The constant management and implementation of differentiated criteria according to the evolution of NS for the supply of HF is fundamental in the continuity of this public policy.

Impacts of the COVID-19 pandemic on the profile and preferences of urban mobility in Brazil: Challenges and opportunities

Daily commuting characteristics were highly affected by the COVID-19 pandemic, since restriction of the movement of people was one of the main preventive measures adopted. Understanding of the effects that the pandemic had on mobility is essential to help in mitigating the problems arising from this crisis, while also providing an opportunity for the implementation of sustainable policies in the post-pandemic period. Therefore, the aim of this study was to identify the impacts of the pandemic on the profile of travel behavior and mobility preferences in Brazil, using a case study of cities located in the state of Rio Grande do Sul. The data obtained from an online survey were modeled using exploratory factor analysis, resulting in the extraction of 15 main factors that explain behavioral changes in mobility due to the effects of the pandemic, as well as future perspectives. In the pandemic period, the use of private vehicles grew as the main mode of transport to the principal activity. Conversely, the use of public transport decreased drastically, due to compulsory measures taken by the health authorities to prevent the spread of the new virus. There was also greater receptivity to the adoption of active mobility, especially the bicycle, although it is necessary to provide better conditions for use of this transport mode. The findings support the development of public policies to reduce urban mobility problems and to provide guidelines for sustainable planning in the post-pandemic period.

Children and adolescents continue to be exposed to early work in Brazil

2 million children and adolescents between 11 and 19 years old have not yet finished basic education and had left school. The current Brazilian scenario reflects the reality in which these children and adolescents are inserted, without sufficient resources for the continuity of basic or elementary education, and often the parents' lack of income leads these young people to seek work, as can be seen in several capitals and inland cities: children selling food at traffic lights, bars, restaurants, and similar situations5. According to a study carried out by Abrinq Foundation (Fundação Abrinq), in the last quarter of 2021, there were about 2.36 million adolescents aged between 14 and 17 years old in the labor market or looking for a job, of which 1.2 million were in child labor in disagreement with Brazilian legislation, including work similar to slavery, and activities harmful to health, development, and morality.

Impact of COVID-19 on Liver Transplant Activity in the USA: Variation by Etiology and Cirrhosis Complications

BACKGROUND AND AIMS

The COVID-19 pandemic has impacted the care of patients with liver disease. We examined impact of COVID-19 on liver transplant (LT) activity in the USA.

METHODS

LT listings in the United Network for Organ Sharing (UNOS) database (April 2018-May 2021) were analyzed to examine the impact of COVID-19 pandemic on the LT activity based on etiology: hepatitis C virus (HCV), alcohol-associated liver disease (ALD), alcoholic hepatitis (AH), and nonalcoholic steatohepatitis (NASH) complications: hepatocellular carcinoma (HCC) and acute-on-chronic liver failure (ACLF) grade 2 or 3) and Model for End-Stage Liver Disease (MELD) score. Joinpoint regression models assessed time trend changes on a log scale.

RESULTS

Of 23,871 recipients (8,995 in the COVID era, April 2018-February 2020), mean age 52 years, 62% men, 61% Caucasian, 32% ALD, 15% HCC, 30% ACLF grades 2-3, and mean MELD score 20.5), monthly LT changes were a decrease of 3.4% for overall LTs and 22% for HCC after September 2020, and increase of 4.5% for ALD since 11/2020 and 17% since 03/2021 for ACLF grade 2-3. Monthly MELD scores increased by 0.7 and 0.36 after June 2020 for HCV and HCC respectively.

CONCLUSIONS

The COVID-19 pandemic has impacted LT activity, with a decrease of LTs especially for HCC, and an increase of LTs for ALD and severe ACLF. Strategies are needed to reorganize cirrhosis patients to overcome the aftereffects of COVID-19 pandemic.

Public assistance, survival, and household trust during the containment period of the first wave of the SARS-CoV-2 pandemic in Togo

This paper analyzes the impact of public assistance during the first wave of the SARS-CoV-2 pandemic with regard to household survival, using data from a two-round survey of 1274 respondents in Togo conducted by the National Institute of Statistics, Economic and Demographic Studies. The analysis uses the propensity score matching method, the probit model, and the discrete endogenous regressor. The first result shows that more than two thirds of respondents experienced income shocks due to the health crisis. The second result shows that public assistance programs have enabled the beneficiary populations to overcome the impact of shocks.

Causation between energy consumption and climate change in the countries with the highest global climate risk

The study aims to examine if there is causation between "energy consumption" and "climate change" through the data of ten countries with the highest Climate Risk Index (CRI) scores. The ten highest CRI score countries include Puerto Rico, Myanmar, Haiti, Philippines, Mozambique, The Bahamas, Bangladesh, Pakistan, Thailand, and Nepal. The annual data for the years 2005-2019 was used because of the data constraints. CRI is selected as the dependent variable. As for the independent variables, the ratios of the energy consumption of the key sectors indicated by the International Energy Agency (IEA) to the total energy consumption are chosen. These key sectors in energy consumption are industry (IND), transportation (TRA), trade and public services (TPS), and housing (HOU). Economic growth (EG), which is one of the main factors affecting climate change in the literature, is included in the model as the control variable. According to the results of the Dumitrescu-Hurlin causality test, there is one-way causality from transportation towards CRI, but not any causality between others. It is evaluated that since the transportation sector is heavily dependent on fossil fuels, it has a strong effect on the amount of CO₂ emissions and a significant determining role on climate change.

Strengthening antimicrobial stewardship activities in secondary and primary public healthcare facilities in India: Insights from a qualitative study with stakeholders

PURPOSE

Examining the existing federal and state policies in place that could strengthen antimicrobial stewardship (AMS) activities in district and sub-district hospitals in India.

METHODS

In-depth interviews were conducted with national and state level policy makers and various stakeholders at a district hospital. For national level, officials from the National Health Systems Resource Centre (NHSRC) were approached. The state of Haryana was selected and officials from Haryana State Health Systems Resource Centre (HSHRC), a state-level counterpart of the NHSRC, along with officials from the Health Department and relevant stakeholders from one of the district hospitals of the Haryana state were selected as participants. The recorded interviews were transcribed verbatim and thematic analysis was done.

RESULTS

Several measurable elements within the existing policies such as National Quality Assurance Program (NQAP) and Kayakalp program, could be leveraged to strengthen AMS activities in district and sub-district hospitals, were identified. These cover aspects such as infection control, standard treatment guidelines (STGs), prescription auditing, essential medicine list (EML), availability of antimicrobials and incentives for meeting quality standards. Revising the EML based on WHO AWaRe classification, incorporating the STGs for common clinical infections from the WHO AWaRe antibiotic book and Indian Council of Medical Research (ICMR), program mandated requirements for dedicated staff/standards for AMS activities and antimicrobial-specific prescription audits as per WHO AMS tool-kit and ICMR AMS guidelines are identified as opportunities for strengthening AMS activities. Further, hindrances in executing existing policies were also identified such as shortage of human resources, reluctance to follow STGs, and limited availability of diagnostic microbiology laboratory services.

CONCLUSION

Implementing NQAS and Kayakalp program in public healthcare facilities are identified as existing well working key programs that aid in improving AMS activities with incorporation of WHO and ICMR recommended practices.

A social method to address the interplay between protected areas and land use policies

During the last decade, several authors have supported the need to integrate protected areas (PAs) with land use planning (LUP) policies to improve nature conservation and promote sustainable and just cities and territories. However, this process presents multiple challenges in different parts of the world. This article introduces and develops a method of analysis for the articulation between protected areas (PAs) and land use planning (LUP) policies from the perspective of social sciences. This combines a diagnostic first stage of content analysis of land use plans at a provincial/regional/statal scale, with a second stage of an in-depth political analysis in some study cases at municipal scale. The first stage involve the spatial identification of all the municipal districts of a selected study area with provincial, national or international PAs and land use plans. Seven questions guide the analysis of those plans in terms of the degree and quality of PAs nominal articulation. This information, in addition to previous normative data, allows for the development of a formula for the comparative analysis and mapping of the institutional vulnerability and risk of those municipal districts. In the second stage, a synchronous substantive (content) and institutional (network of stakeholders) analysis of land use policies in selected municipal cases is carried out. To this end, interviews, surveys, media analysis and public documents are conducted. Thus, this method combined different focus scales and quali-quantitative techniques to advance the knowledge of key variables intended for improving political coordination in the promotion of nature conservation. This model was tested in the case of the province of Buenos Aires (Argentina).•A social sciences' method for studying land use planning and protected areas coordination is introduced.•The method combines two stages and scales: diagnostic content analysis of land use plans in a provincial/regional/statal scale plus an in-depth political analysis in study cases at a municipal scale.•This method is useful for estimating normative vulnerability and risk, identifying key political variables for coordination, and making public policy recommendations according to the current conservation paradigm.

Making medicines in post-colonial Ghana: State policies, technology transfer and pharmaceuticals market

The COVID-19 epidemic has highlighted the risks of shortages resulting from dependence on medicine imports. Today's situation where a few companies in the Global North control COVID-19 vaccine production is having dire consequences on African countries' access. However, the challenges surrounding local production of medical products in Africa are long-standing issues dating back to independence. Using Ghana as a case study, this paper looks primarily at how the dependence on medicine imports can be understood as the result of policies implemented since independence, as well as the changes that the Ghanaian State has undergone in reaction to international events and the evolution of the structure of global pharmaceutical capital. It examines the policies associated with the Ghanaian State's project to promote local pharmaceutical production, from independence to the present, and the role that non-state actors such as pharmaceutical companies have played. Based on an historical political economy approach, it highlights how the roles of the State and its forms of intervention have evolved over time, from planning (right after independence), to implementing (during the global crisis of the 1970s-1980s), and finally to regulating (from the 1990-2000s onward). This paper draws on 14 months of PhD research fieldwork (2014-2018). It consists of interviews (n = 50) with Ghanaian actors in the pharmaceutical sector, observations in a pharmaceutical plant in Accra, and research into archives at the Public Records and Archives Administration Department (PRAAD) of the Ministry of Industry.

Slums and pandemics

How do slums shape the economic and health dynamics of pandemics? A difference-in-differences analysis using millions of mobile phones in Brazil shows that residents of overcrowded slums engaged in less social distancing after the outbreak of Covid-19. We develop and calibrate a choice-theoretic equilibrium model in which individuals are heterogeneous in income and some people live in high-density slums. Slum residents account for a disproportionately high number of infections and deaths and, without slums, deaths increase in non-slum neighborhoods. Policy analysis of reallocation of medical resources, lockdowns and cash transfers produce heterogeneous effects across groups. Policy simulations indicate that: reallocating medical resources cuts deaths and raises output and the welfare of both groups; mild lockdowns favor slum individuals by mitigating the demand for hospital beds, whereas strict confinements mostly delay the evolution of the pandemic; and cash transfers benefit slum residents to the detriment of others, highlighting important distributional effects.

Nutrition policies in Germany: a systematic assessment with the Food Environment Policy Index

OBJECTIVE

To systematically assess Germany's nutrition policies, to benchmark them against international best practices and to identify priority policy actions to improve population-level nutrition in Germany.

DESIGN

We applied the Food Environment Policy Index (Food-EPI), a methodological framework developed by the International Network for Food and Obesity/non-communicable Diseases Research, Monitoring and Action Support (INFORMAS) network. Qualitative content analysis of laws, directives and other documents formed the basis of a multistaged, structured consultation process.

SETTING

Germany.

PARTICIPANTS

The expert consultation process included fifty-five experts from academia, public administration and civil society.

RESULTS

Germany lags behind international best practices in several key policy areas. For eighteen policy indicators, the degree of implementation compared with international best practices was rated as very low, for twenty-one as low, for eight as intermediate and for none as high. In particular, indicators on food taxation, regulation of food marketing as well as retail and food service sector policies were rated as very low to low. Identified priority actions included the binding implementation of nutrition standards for schools and kindergartens, a reform of the value added tax on foods and beverages, a sugar-sweetened beverage tax and stricter regulation of food marketing directed at children.

CONCLUSIONS

The results show that Germany makes insufficient use of the potential of evidence-informed health-promoting nutrition policies. Adopting international best practices in key policy areas could help to reduce the burden of nutrition-related chronic disease and related inequalities in nutrition and health in Germany. Implementation of relevant policies requires political leadership, a broad societal dialogue and evidence-informed advocacy by civil society, including the scientific community.

Operating, financial and investment impacts of Covid-19 in SMEs: Public policy demands to sustainable recovery considering the economic sector moderating effect

Currently, many institutions and academics are working to establish strategies of economic recovery with the aim of mitigating the short- and long-term impacts of the COVID-19 crisis. The main aim of this study is to analyze how this crisis has impacted Spanish SMEs, considering their operating, financial, and investment activities. We also analyze the initiatives or public policies that SME managers consider necessary in order to face the effects of COVID-19. To do this, an empirical study has been carried out based on information from 612 Spanish SMEs, estimating a PLS research model and multigroup analysis that considers the activity sector as a moderating variable. The results are useful to companies and different economic and social agents, providing information to facilitate decision-making to overcome pandemic crisis mainly in the economic and strategic spheres.

Future assessment of the impact of the COVID-19 pandemic on the electricity market based on a stochastic socioeconomic model

This paper proposes a time-series stochastic socioeconomic model for analyzing the impact of the pandemic on the regulated distribution electricity market. The proposed methodology combines the optimized tariff model (socioeconomic market model) and the random walk concept (risk assessment technique) to ensure robustness/accuracy. The model enables both a past and future analysis of the impact of the pandemic, which is essential to prepare regulatory agencies beforehand and allow enough time for the development of efficient public policies. By applying it to six Brazilian concession areas, results demonstrate that consumers have been/will be heavily affected in general, mainly due to the high electricity tariffs that took place with the pandemic, overcoming the natural trend of the market. In contrast, the model demonstrates that the pandemic did not/will not significantly harm power distribution companies in general, mainly due to the loan granted by the regulator agency, named COVID-account. Socioeconomic welfare losses averaging 500 (MR$/month) are estimated for the equivalent concession area, i.e., the sum of the six analyzed concession areas. Furthermore, this paper proposes a stochastic optimization problem to mitigate the impact of the pandemic on the electricity market over time, considering the interests of consumers, power distribution companies, and the government. Results demonstrate that it is successful as the tariffs provided by the algorithm compensate for the reduction in demand while increasing the socioeconomic welfare of the market.

Policies for supporting the regional circular economy and sustainability

The Circular Economy and Sustainability are among the greatest challenges faced by policymakers, producers, and consumers. Circular Economy processes demand less from the environment since they can minimize waste generation and, hence, can be powerful tools to combat the negative effects of climate change. Additionally, following subsidiarity principles, public policies supporting the Circular Economy should be designed at the lowest levels of public administrations-this provides huge opportunities for regional governments to design, implement and monitor these policies. This editorial of the special issue explores and discusses implications for those policies before introducing the five papers published in the special issue dedicated to policies for regional economy and sustainability. While some of the papers attempt to conceptualize sustainable development through a microeconomic perspective, others have a clear macroeconomic empirical focus. In consequence, this special issue provides a rich body of work for further Circularity and Sustainability nexus studies.

Homeless People, COVID-19 and the Insufficient and Discriminatory Measures Adopted by the City of Buenos Aires's Government

The COVID-19 pandemic, which has had a high impact in the Latin American region since March 2020, has produced the dictation of various measures in order to, in principle, guarantee better health conditions for the population. In this paper, I will focus on the situation of homeless people and the measures adopted by the Government of the city of Buenos Aires. I will analyze two judicial decisions in which the measures adopted were questioned. However, these cases were resolved by the judges without applying a robust argument of equality. This analysis will allow me to demonstrate that even though the aim of these measures was to protect disadvantaged people, the appropriate measures were not taken (by omission or insufficiency). My claim is that in the context of the pandemic we needed more than only preventive measures - social distancing. In societies marked by situations of structural inequality suffered by large groups even in emergencies, it is the most vulnerable who should be in the center of the scene when developing public policies.

NAFLD: Challenges and opportunities to address the public health problem in Latin America

Non-alcoholic fatty liver disease (NAFLD) is reaching epidemic proportions worldwide. Collectively, Latin American countries have some of the highest obesity rates in the world and the fastest-growing prevalence of type 2 diabetes mellitus (T2DM). Since obesity and T2DM are intrinsically linked with NAFLD, epidemiological projections are worrisome. In addition to this adverse epidemiological setting, the region of Latin America faces unique challenges and obstacles to addressing the growing burden of NAFLD. In this article, on the occasion of the International NASH Day on June 10, 2021, we describe the main challenges and opportunities to improve care of people living with NAFLD in Latin America. Among the major challenges to be tackled are: lack of disease awareness, limited educational opportunities for healthcare personnel and general public, health system fragmentation, and lack of effective strategies for the prevention and effective treatment of NAFLD and common comorbidities, namely obesity and T2DM. Wide dissemination of current concepts on NAFLD, and extensive collaboration between scientific societies, governments, non-governmental organizations, pharmaceutical industry, and other stakeholders is urgently needed to advance the NAFLD public health policies agenda that allows us to address this disease with a whole of society approach.

Identifying stakeholders and discussing a strategy for the participatory management of a protected area: the case of Engenho Pequeno, in Rio de Janeiro State, Brazil

This paper identifies the potential main social actors involved in and affected by the conservation and use of the Environmental Protection Area (EPA) of Engenho Pequeno, in Rio de Janeiro State, Brazil, and discusses how environmental education can be shaped to engage them in participatory, socially progressive and environmentally sustainable management for that area. Therefore, semi-structured interviews were conducted with individuals and entities related to the EPA. The snowball method complemented the mapping of non-official social actors. The discussion was based on the critical approach of environmental education, polycentric governance, adaptive management, environmental advocacy and case studies about education in protected areas. Results showed nine key stakeholders to be considered in a network program for the EPA's participatory management, including government, schools, local and nearby residents and religious groups. In the end, we recommend the hosting of a one day workshop, built around existing local and national environmental goals, as an entry point for trust building and the search for shared interests.

[The preventive efforts of the Spanish autonomous regions and socio-economic inequality in childhood obesity or overweight]

OBJECTIVE

To explore trends in childhood overweight/obesity according to socio-economic status and in relation to the preventive effort developed by the Spanish autonomous regions.

METHOD

A series of multilevel cross-sectional studies were conducted using data from different waves of the Spanish National Health Survey, namely 2003, 2006, 2011 and 2017. Hierarchical logistic regression models were estimated, with individuals (level 1) nested within the region-period of study (level 2) and these, in turn, within the region (level 3). The main independent variables were the average effort made by the Spanish autonomous regions in child overweight-obesity prevention policies and the change in the effort made in these policies over the periods studied.

RESULTS

The likelihood of obesity and/or overweight increases substantially if the adult respondent in the household is also obese or overweight. The joint effect of the policies implemented by the autonomous regions is associated with a significant decrease in prevalence only for children belonging to high and middle social classes (odds ratio [OR]: 0.89, 95% confidence interval [95%CI]: 0.82-0.96, and OR: 0.93, 95%CI: 0.88-0.97, respectively).

CONCLUSIONS

The policies implemented by the Spanish autonomous regions seem to have a limited capacity to achieve significant reductions in the prevalence of childhood overweight and obesity. The results suggest that it is the middle and upper-middle class groups that seem to benefit most from these policies, which could indirectly contribute to increasing inequalities in childhood obesity.

An overview of plastic straw policies in the Americas

Although plastic straws account for a small fraction of urban residue, they are also found in marine and coastal waste, raising concerns in the community and resulting in policies to curb or ban improper disposal. These policies are still little documented and discussed in the scientific literature. This review article aims at surveying, categorizing and analyzing existing regulations on the American continent (North, Central and South America and the Caribbean). The regulations were analyzed in terms of straw bans; obligations regarding the type of raw material used in manufacturing; accessibility-related exceptions to bans; and the adoption of environmental education measures. A total of 363 regulations enacted in 62.8% of American countries were examined, 37% of which need technical standards to support their requirements. In Central America and the Caribbean, it is primarily the regulations that provide environmental education. Locations with a strong beach tourism economy have enacted plastic straw regulations.

Paving New Roads Towards Biodiversity-Based Drug Development in Brazil: Lessons from the Past and Future Perspectives

Although Brazil gathers two fundamental features to occupy a leading position on the development of biodiversity-based medicines, the largest flora on earth and a broad tradition on the use of medicinal plants, the number of products derived from the national genetic heritage is so far modest, either as single drugs or as herbal medicines. This article highlights some aspects that may have contributed to the low rates of success and proposes new insights for innovation. We initially approach the use of medicinal plants in Brazil, molded by its ethnic diversity, and the development of the local pharmaceutical industry. A discussion of some governmental initiatives to support plant-based drug development is then presented. Employing the economic concept of “middle-income trap,” we further propose that Brazil is stuck in a “middle-level science trap,” since the increase in the number of scientific publications that launched the country to an intermediate publishing position has not been translated into drug development. Two new approaches to escape from this trap are presented, which may result in innovative drug development. The first is based on the exploitation of the antifragility properties of herbal products aiming to investigate non-canonical pharmacodynamics mechanisms of action, aligned with the concepts of system biology. The second is the manufacture of herbal products based on the circular economy principles, including the use of byproducts for the development of new therapeutical agents. The adoption of these strategies may result in innovative phytomedicines, with global competitiveness.

Brazilian Presidential Pronouncements in the Pandemic: Effectiveness in Crisis Communication and Rule Properties

This work analyzed the six official statements of the president of Brazil that were broadcast on radio and television during the first 4 months of COVID-19 contamination in the country, regarding the efficacy in communicating the crisis and dimensions of rules. We observed a higher frequency of ineffective excerpts in the statements, especially in the categories "effective fear incitement" and "respect." The categories "speed" and "expression of empathy" showed high efficacy. Additionally, there was a higher recurrence of implicit and inaccurate rules and rules opposing the recommendations of experts. These results indicate that the analyzed statements were ineffective in crisis communication and control of behaviors combating the pandemic in Brazil. The analysis of governmental practices by behavioral science can be useful in the planning of public policies.

Understanding the dairy production systems in rural settlements in the Brazilian semi-arid region: characterization, typology, and holistic perception

The objective of this study was to characterize and typify dairy farms and to evaluate society's perception of dairy production in rural settlements in the Brazilian semi-arid region. A questionnaire containing questions related to socioeconomic, livestock, physical, herd management, and production indicators was applied to 17 milk farmers for typological analysis. A second questionnaire was subsequently applied to the same 17 farmers for the holistic perception of dairy farming in rural settlements, in addition to 47 technicians in the area of animal science and 140 laypeople. Milk samples were collected in the settlement's community cooling tank, while the water used for milking management was collected in the milking parlor at the 17 farms. Multivariate analysis techniques and thematic analysis were performed. Three dairy production systems were identified: low production group (0-25 L), medium production group (25-50 L), and high production group (50-100 L). The physicochemical properties (composition, density, and cryoscopy) of milk attended the Brazilian regulation values. The microbiological parameters of milk and water used for milking are at odds with regulations. Regarding the typology, the indicators, livestock, and productivity showed discriminatory power (P < 0.05) between the productive systems. The responses from the segments of society showed different views on dairy production in rural settlements. It is concluded that the dairy farmers have low education and the cleaning product and water used in milking are out of regulation. The livestock and production indicators typified mainly dairy farms, while the holistic perception showed a lack of efficiency in rural extension, ignorance of the potential of the productive system. Finally, the creation of public policies focusing on the development of the milk production system in settlements is recommended.

Do the determinants of the COVID-19 mortality rate differ between European Union countries with different adult population pyramids?

Objective

This work aims to determine whether variables such as health expenditure, the total number of physicians, available beds or restrictive public health policies are determinants of the number of deaths due to COVID-19 in the European Union (EU) countries.

Study design

This is a statistical study, evaluating variables associated with COVID-19 mortality in the EU.

Methods

The association of these variables is analysed by means of multiple regression. Three groups of countries are distinguished according to the percentage of population over 65 years of age (terciles), to determine whether the variables affect the mortality rate according to the concentration of the adult population.

Results

In the first tercile, a higher number of physicians will contribute to lower mortality rates. In countries in the second tercile, the number of physicians is not relevant, but healthcare expenditure or the number of beds is. In the older age group, neither variable is significant.

Conclusions

The recruitment of more physicians may contribute to a reduction in deaths in countries with a lower proportion of adult population.

Assessing the nationwide impact of COVID-19 mitigation policies on the transmission rate of SARS-CoV-2 in Brazil

COVID-19 is now identified in almost all countries in the world, with poorer regions being particularly more disadvantaged to efficiently mitigate the impacts of the pandemic. In the absence of efficient therapeutics or large-scale vaccination, control strategies are currently based on non-pharmaceutical interventions, comprising changes in population behavior and governmental interventions, among which the prohibition of mass gatherings, closure of non-essential establishments, quarantine and movement restrictions. In this work we analyzed the effects of 707 governmental interventions published up to May 22, 2020, and population adherence thereof, on the dynamics of COVID-19 cases across all 27 Brazilian states, with emphasis on state capitals and remaining inland cities. A generalized SEIR (Susceptible, Exposed, Infected and Removed) model with a time-varying transmission rate (TR), that considers transmission by asymptomatic individuals, is presented. We analyze the effect of both the extent of enforced measures across Brazilian states and population movement on the changes in the TR and effective reproduction number. The social mobility reduction index, a measure of population movement, together with the stringency index, adapted to incorporate the degree of restrictions imposed by governmental regulations, were used in conjunction to quantify and compare the effects of varying degrees of policy strictness across Brazilian states. Our results show that population adherence to social distance recommendations plays an important role for the effectiveness of interventions and represents a major challenge to the control of COVID-19 in low- and middle-income countries.

Assessing the nationwide impact of COVID-19 mitigation policies on the transmission rate of SARS-CoV-2 in Brazil

COVID-19 is now identified in almost all countries in the world, with poorer regions being particularly more disadvantaged to efficiently mitigate the impacts of the pandemic. In the absence of efficient therapeutics or large-scale vaccination, control strategies are currently based on non-pharmaceutical interventions, comprising changes in population behavior and governmental interventions, among which the prohibition of mass gatherings, closure of non-essential establishments, quarantine and movement restrictions. In this work we analyzed the effects of 707 governmental interventions published up to May 22, 2020, and population adherence thereof, on the dynamics of COVID-19 cases across all 27 Brazilian states, with emphasis on state capitals and remaining inland cities. A generalized SEIR (Susceptible, Exposed, Infected and Removed) model with a time-varying transmission rate (TR), that considers transmission by asymptomatic individuals, is presented. We analyze the effect of both the extent of enforced measures across Brazilian states and population movement on the changes in the TR and effective reproduction number. The social mobility reduction index, a measure of population movement, together with the stringency index, adapted to incorporate the degree of restrictions imposed by governmental regulations, were used in conjunction to quantify and compare the effects of varying degrees of policy strictness across Brazilian states. Our results show that population adherence to social distance recommendations plays an important role for the effectiveness of interventions and represents a major challenge to the control of COVID-19 in low- and middle-income countries.

Have countries offered the best data to the Pan American Health Organization? Evidence of potential inconsistencies found in a study on alcohol policies in Brazil

OBJECTIVE

The objective of this study was to verify the agreement between the alcohol policies score estimated from documental analysis of Brazilian federal regulatory documents (RD), with primary data collection, and the results previously presented by the Pan American Health Organization (PAHO) in its Alcohol Policy Scoring (APS) report.

STUDY DESIGN

Document identification and content analysis.

METHODS

Documental research was carried out in two phases: a document identification and content analysis. In the first phase, we carried out the search, identification, and systematization of laws, decrees, and federal ordinances in Brazil, with primary data collection. The second phase consisted of three steps: 1) an RD content analysis and classification into the 10 PAHO/World Health Organization (WHO) policy domains; 2) a score estimation of alcohol policies, based on the APS instrument attached to their report; and 3) comparison of the results for Brazil presented at the APS report and the one estimated by the researchers.

RESULTS

The study showed divergences between the results for APS published by PAHO about Brazil and the one achieved with primary data collection. 1146 federal promulgated RD were identified, of which 21 were eligible for content analysis. Only the domains "Community and workplace action" (Domain 3) and "Reducing the public health impact of illicit and informally produced alcohol" (Domain 9) had convergent scores. On the other domains, usually the APS score estimated by PAHO differs from the one estimated with the primary data collection.

CONCLUSIONS

We conclude that Brazil is not providing the best data for PAHO/WHO estimate its APS report, leading to the dissemination of imprecise results worldwide.

Health capabilities and the determinants of infant mortality in Brazil, 2004-2015: an innovative methodological framework

BACKGROUND

Despite the implementation of a set of social and health policies, Brazil has experienced a slowdown in the decline of infant mortality, regional disparities and persistent high death levels, raising questions about the determinants of infant mortality after the implementation of these policies. The objective of this article is to propose a methodological approach aiming at identifying the determinants of infant mortality in Brazil after the implementation of those policies.

METHOD

A series of multilevel panel data with fixed effect nested within-clusters were conducted supported by the concept of health capabilities based on data from 26 Brazilian states between 2004 and 2015. The dependent variables were the neonatal, the infant and the under-five mortality rates. The independent variables were the employment rate, per capita income, Bolsa Família Program coverage, the fertility rate, educational attainment, the number of live births by prenatal visits, the number of health professionals per thousand inhabitants, and the access to water supply and sewage services. We also used different time lags of employment rate to identify the impact of employment on the infant mortality rates over time, and household income stratified by minimum wages to analyze their effects on these rates.

RESULTS

The results showed that in addition to variables associated with infant mortality in previous studies, such as Bolsa Família Program, per capita income and fertility rate, other factors affect child mortality. Educational attainment, quality of prenatal care and access to health professionals are also elements impacting infant deaths. The results also identified an association between employment rate and different infant mortality rates, with employment impacting neonatal mortality up to 3 years and that a family income below 2 minimum wages increases the odds of infant deaths.

CONCLUSION

The results proved that the methodology proposed allowed the use of variables based on aggregated data that could hardly be used by other methodologies.

Public health matters: why is Latin America struggling in addressing the pandemic?

This article examines how Argentina, Brazil, Chile, Colombia, Mexico, and Peru addressed the COVID-19 pandemic and the effectiveness of these policy responses from the date each country declared a sanitary emergency, between middle and late March 2020 to the most recent available measurement on 23 September 2020. To analyze how governments responded to the COVID-19 pandemic in these six Latin American countries, we use an index of government response, created by the University of Oxford. To explore the effects of these governmental mitigation policies on reducing social mobility, we use Google mobility reports. We also analyze how these policies may have influenced COVID-19 mortality rates. Overall, the results showed that both timelier and more stringent implementation of the public policies analyzed to address the COVID-19 pandemic seem to be associated with higher mobility reductions and lower mortality rates. We draw five policy lessons from the way each country implemented these mitigation policies. KEY MESSAGE: Timelier and more stringent implementation of these public policies may contribute to a higher mobility reduction in several public spaces and to lower mortality rates. The effectiveness of the closure and containment policies in each Latin American country seem to depend on the degree of compliance of their respective populations and to their socioeconomic living conditions. Economic and social policies of income support and debt relief provided by governments allowed people to comply with closure and containment policies. Health systems should maintain high levels of policy stringency together with effective surveillance through testing policy and contact tracing.

COVID-19: Public health issues and ethical dilemmas

There are various ethical dilemmas faced by the healthcare sectors, especially at times of pandemics and health emergencies, which is more prominently visible in the case of public healthcare sectors. Keeping this into consideration, the concerned study had emphasized exploring the ethical dilemmas that are faced by the public health care sectors across the globe, in fighting the COVID-19 pandemic situations in the current period. The secondary and qualitative information collected for the concerned study has been analyzed and interpreted using the thematic analytical framework and following the inductive approach. Substantial evidence has revealed that the public health care system globally has been facing a scarcity of resources and allocation of responsibilities to the care provider. There has been disparity noted in the implementation of public health care ethics. The importance of ethics in the public healthcare system cannot be denied however, the issues noted during this pandemic situation have been associated with lack of accountability, issues in resource allocation, and loss of trustworthiness in the healthcare provisions. Hence, there is a need for changes to be made in the public policies and health policies so that the public health institutions are more prepared to deal with emergencies such as the one created by the COVID-19 pandemic.

Les politiques publiques affectant négativement les familles demandeuses d'asile avec des jeunes de 0 à 5 ans au Québec

In 2019, 30,615 asylum claims were made in Quebec, representing almost half of the claims made in Canada. Asylum-seeking families with young children (0 to 5 years) represent a significant proportion of this population. Canada, as well as Quebec, have a responsibility to protect asylum seekers and to ensure that public policies promote health and well-being, especially among children. However, certain existing public policies exclude asylum seekers and are negatively affecting families. This commentary seeks to raise awareness among all those involved in policymaking, especially decision-makers, regarding asylum-seekers and three policy domains that are contributing to poverty, social isolation, and reduced access to care among asylum-seeking families with young children. These include the lack of eligibility for child benefits, the limited access to affordable daycare, and barriers to accessing family doctors. Consequently, both parents and children suffer impacts to their health and well-being. We are calling on our governments to assume their responsibilities and eliminate these inequities, and to ensure that the health of asylum seekers is considered in all policies.

Reducing food loss and waste: Five challenges for policy and research

Despite broad agreement in policy circles on the need to reduce food loss and waste (FLW), considerable gaps in information still exist. This paper identifies policy-relevant information gaps, summarizes recent research that tries to fill these gaps and identifies five challenges for researchers, policymakers and practitioners in reducing FLW. The five challenges identified are: (i) measuring and monitoring FLW, (ii) assessing benefits and costs of FLW reduction and the tradeoffs involved, (iii) designing FLW-related policies and interventions under limited information, (iv) understanding how interactions between stages along food value chain and across countries affect outcomes of FLW reduction efforts, (v) preparing for income transitions and the shifting relative importance of losses and waste as economies develop.

Polybrominated diphenyl ethers and organochloride pesticides in the organic matter of air suspended particles in Mexico valley: A diagnostic to evaluate public policies

The presence of organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs) was analysed in air particulate matter ≤ 2.5 μm (PM_2.5) and ≤10 μm (PM₁₀) collected in the Metropolitan Zone of Mexico Valley (MZMV), during 2013 and 2014, respectively. Spatial and seasonal distributions of PM and their organic content named solvent extracted organic matter (SEOM) were determined. PM mass concentration and SEOM/PM ratios were compared with previous studies in 2006 in Mexico City. PM_2.5 concentration was like found in 2006, however, PM₁₀ decreased ∼43%. The SEOM/PM₁₀ ratio was kept constant, suggesting a decrease in SEOM as well as PM₁₀ emitted from natural sources, probably as a result of changes in the land use due to urban growth. A decrease ∼50% SEOM/PM_2.5 ratio was observed in the same period, linked to adequate strategies and public policies applied by the local and federal governments to control the organic matter emitted from anthropogenic sources. Seven out of sixteen OCPs and five out of six PBDEs were found. The most common POPs were endosulfan I, endosulfan II, endosulfan sulfate, BDE-47 and BDE-99, present on >90% of the sampling days. OCPs in PM_2.5 and PBDEs in PM₁₀ showed seasonal variability. Higher PBDEs concentration in both particle sizes were observed at east and southeast of the MZMV, where one of the biggest landfills and wastewater treatment plants are located. OCPs in PM₁₀ were mainly emitted from agricultural areas located to the southwest, southeast and east of the MZMV. OCPs in PM_2.5 showed a regional contribution from the north and introduced into the valley. OCP degradation products were dominant over native OCPs, indicating no fresh OCP use. POPs comparison with other cities was made. Agreements and commissions created by the Mexican government reduced OCPs emissions, however, more effort must be made to control PBDE emission sources.

Public policies and tax evasion: evidence from SAARC countries

In compliance with the socioeconomic theory, the study has strived to investigate the impact of economic and non-economic public policies on tax evasion using panel data of 7 SAARC countries covering the period from 1998 to 2015. The study has applied the ordinary least square with fixed effect and random effect models to analyze the data assembled. The result of the study implies that the higher the degree of economic freedoms, the lower the tax evasion. More specifically, the government policies about property rights, monetary freedom, fiscal freedom and investment freedom have a negative influence on taxpayers' choices of tax evasion while financial freedom result shows a positive effect on tax evasion. Additionally, there is a negative impact of public sector governance and religiosity on tax evasion, which implies the higher the public sector governance and the higher the religious faith amid the people, the lower the degree of tax evasion. The findings of the study are supposed to offer the governments, tax authorities, and research scholars the valuable insights into public policies for reducing the tax evasion to a significant extent.

[The update of the limits for low risk alcohol consumption. An opportunity for implementing strategies for early intervention and brief interventions in Spain.]

This work places in context Spain's recent update of the defined limits for low risk alcohol consumption to 20g/day for men and 10g/day for women, and summarises data on the impact on individual health and the social costs of alcohol consumption. Furthermore, it considers the challenges that arise related to awareness of the risks of alcohol consumption, in the general population and among health professionals. The paper also reviews the implications of the new definitions in relation to the most effective policies for reducing alcohol-related harm. It looks at this from a public health perspective with particular emphasis on how to seize the opportunity to better promote the implementation of strategies for early identification and brief interventions in primary care in this country.

United but divided: Policy responses and people's perceptions in the EU during the COVID-19 outbreak

To understand the public sentiment toward the measures used by policymakers for COVID-19 containment, a survey among representative samples of the population in seven European countries was carried out in the first two weeks of April 2020. The study addressed people's support for containment policies, worries about COVID-19 consequences, and trust in sources of information. Citizens were overall satisfied with their government's response to the pandemic; however, the extent of approval differed across countries and policy measures. A north-south divide in public opinion was noticeable across the European states. It was particularly pronounced for intrusive policy measures, such as mobile data use for movement tracking, economic concerns, and trust in the information from the national government. Considerable differences in people's attitudes were noticed within countries, especially across individual regions and age groups. The findings suggest that the epidemic acts as a stressor, causing health and economic anxieties even in households that were not directly affected by the virus. At the same time, the burden of stress was unequally distributed across regions and age groups. Based on the data collected, we draw lessons from the containment stage and identify several insights that can facilitate the design of lockdown exit strategies and future containment policies so that a high level of compliance can be expected.

United but divided: Policy responses and people's perceptions in the EU during the COVID-19 outbreak

To understand the public sentiment toward the measures used by policymakers for COVID-19 containment, a survey among representative samples of the population in seven European countries was carried out in the first two weeks of April 2020. The study addressed people's support for containment policies, worries about COVID-19 consequences, and trust in sources of information. Citizens were overall satisfied with their government's response to the pandemic; however, the extent of approval differed across countries and policy measures. A north-south divide in public opinion was noticeable across the European states. It was particularly pronounced for intrusive policy measures, such as mobile data use for movement tracking, economic concerns, and trust in the information from the national government. Considerable differences in people's attitudes were noticed within countries, especially across individual regions and age groups. The findings suggest that the epidemic acts as a stressor, causing health and economic anxieties even in households that were not directly affected by the virus. At the same time, the burden of stress was unequally distributed across regions and age groups. Based on the data collected, we draw lessons from the containment stage and identify several insights that can facilitate the design of lockdown exit strategies and future containment policies so that a high level of compliance can be expected.

Equality and poverty: views from managers and professionals from public services and household heads in the Belo Horizonte Metropolitan Area, Brazil

BACKGROUND

Tackling poverty requires reconsideration of quantitative factors related to "who" is poor and by "how much" and qualitative factors addressing "what poverty means in these individuals' lives". Greater understanding is required concerning the types of access actually used by families in poverty in attempts to meet their basic needs. Poverty must be addressed based on the question: "Inequality of what?" It is in reflecting on the realities of such groups when their basic needs are not met that public policies can be improved and implemented with legitimate priorities.

OBJECTIVE

Describe coverage and access to public health, education and social assistance services and the related effects on the quality of life of families in extreme poverty.

METHODS

An exploratory mixed methods study was conducted applying Amartya Sen's "Basic Capability Equality" framework, with: 1) 27 interviews with managers and professionals from public services serving territories with extreme poverty; 2) Survey with a systematic proportionate stratified sample of 336 heads of households in extreme poverty from a total 2605 families. The resulting data was analyzed with thematic content analysis and descriptive statistics, respectively.

RESULTS

The managers and professionals described the lives of families in extreme poverty with phrases such as, "These people suffer. Sadness weighs on their lives!" and "Depression is the most common illness". Their precarious circumstances and inadequate access were cited as causes. Quality of life was considered bad or very bad by 41.4% of heads of households. A total income of less than one-third of the minimum wage was received by 56.9% of the sample. One or more people were unemployed in the family in 55.8% of cases. For 53.3% of heads of households, public services "did not meet any or few of their needs". The main social determinants of health were described as: alcohol and drugs (68.8%); lack of good health care (60.7%); and absence of income/work (37.5%). The following were identified as solutions to improve their quality of life: (1) health (40.5%); (2) education (37.8%); and (3) employment (44.6%).

CONCLUSIONS

The social determinants of poverty and health must be addressed jointly through intersectoral public policies and egalitarian mechanisms that promote investment in social protection.

Street Food, Food Safety, and Regulation: What is the Panorama in Colombia?

ABSTRACT

Public management of street food is a challenge in many countries. In Colombia, despite the extent of the economic, social, and food contributions of the segment and the concern from the public health perspective, the amount of research on the subject still remains insufficient. Thus, this study aimed to establish a panorama of the street food trade in Colombia, considering its mode of operation, food security, and regulatory context, based on the scientific literature published between 2000 and 2018. A literature review was carried out in the Medline, SciELO, LILACS, Scopus, Redalyc, and Google Scholar databases, as well as in the University of Colombia's institutional repositories and scientific books. A set of 19 publications were selected and evaluated for three dimensions-work and culture, food safety, and regulation-according to the objectives and methodologies applied. In category 1, relative to work and culture, five studies were retrieved (26.3%), highlighting the economic and social contribution of the sector and the protection of food cultural heritage. Category 2, referring to hygiene and microbiological safety in the activity, covers 11 publications (57.9%) and comprised the largest research field of interest in the country. Among the food pathogens surveyed, Salmonella spp. were the most investigated, registering nonconformity in the samples (6.55%). Category 3, with three articles (15.8%), covered public policies and regulation of the segment, highlighting the challenges to regulating the sector and the need for intersectional articulation in administrative policies. The results confirm both the relevance of the segment to food security and the concern with microbiological hazards, demanding strategies to improve its regulation and functioning in the country, with the aim of protecting the health of consumers.

HIGHLIGHTS

Waste management drivers towards a circular economy in the global south - The Colombian case

Circular Economy (CE) turned into one of the most popular topics worldwide for presenting itself as the solution to problems linked to the traditional "take-make-consume-dispose" system. But, how can CE be addressed as public policies worldwide? While there are ambitious and committed strategies in the European Union and Asia, the path that emerging economies are taking is poorly researched. Therefore, we selected Colombia, a Latin American country which is beginning to implement new public policies that are on par with global concerns. Furthermore, its waste management panorama has been transformed in recent decades due to its legal framework restructuring, differently than others in the region. This article aimed to elucidate which drivers have influenced the waste management policies in Colombia based on its historical context and how these drivers impacted Municipal Waste Management (MWM) systems. Amongst the principal drivers identified, we highlight "financial sustainability" and "inclusive recycling", which have allowed improvements towards a more sustainable waste management in the country. Moreover, it was possible to understand how the current legal framework was structured and its future challenges. This study constitutes a knowledge base for scholars and policymakers from other emerging economies, creating a potential to verify the relationship and antagonisms between waste management drivers and how they affect public policy implementation.

Current situation of polycyclic aromatic hydrocarbons (PAH) in PM2.5 in a receptor site in Mexico City and estimation of carcinogenic PAH by combining non-real-time and real-time measurement techniques

Air pollution is a public health concern. Polycyclic aromatic hydrocarbons (PAH) are ubiquitous atmospheric pollutants contained in the atmospheric aerosol. PAH in particulate matter with diameters ≤2.5 µm (PM_2.5) represent a human health risk due to their toxic properties. In this study, PAH in PM_2.5 at a receptor site of Mexico City during the dry cold season were determined. The most abundant PAH (median, 10-90th percentile, pg m^-3) were benzo[ghi]perylene (467, 291-697), followed by pyrene (427, 218-642). A decrease around 40% in the carcinogenic PAH onto PM_2.5 was calculated with respect to the same PAH measured a decade ago, at the same receptor site, despite of increase in vehicle fleet. The PAH decrease trend agrees with the decrease trend of CO, NO and NO₂, released into the air by similar emission sources than PAH. Control emissions strategies implemented by local and federal authorities are discussed. PAH analyses were carried out by non-real-time and real-time methods. The PAH non-real-time method involved PM_2.5 sampling, sample treatment and gas chromatography-mass spectrometry analysis. The PAH real-time method involved the use of a photoelectric aerosol sensor (PAS). The PAH determination by non-real time method was selective and efficient, with recoveries between 75 ± 14% and 98 ± 26%. By combining non-real-time and real-time methodologies, multivariate regression models were obtained based on PAS response, NO₂ and wind speed to estimate PAH in PM_2.5 at low-cost (r² = 0.59 to r² = 0.89). Fossil fuel combustion from vehicles was the major source around the sampling site. Diagnostic ratios (DR) based on retene, chrysene, and triphenylene, suggested biomass burning emission sources. Photo-oxidation in sunny months was observed based on benzo[a]pyrene, benzo[ghi]perylene, benz[a]anthracene, indeno[1,2,3-cd]pyrene and black carbon. The correlation analyses suggested transport of PM_2.5, O₃, BC and SO₂ to the sampling site, and local emissions of PAH, NO and CO.