Nurturing future leaders for nature: the example of the UK's National Education Nature Park

This piece reviews the evidence on the effect that engaging with nature has on school-age children's future attitudes and behaviour towards nature. It also looks into the impact engaging with nature has on children and young people's physical, mental and personal development and the evidence on how much time children in England are spending in natural environments. It then presents a UK Government project, the National Education Nature Park (NENP), intended to increase children in England's access to nature by developing nature spaces within the grounds of educational institutions. It concludes with suggestions for how the implementation of the NENP could be used to learn more about the effect that engaging with nature has on children alongside understanding how school-based nature projects could benefit the local environment. This article is part of the theme issue 'Bringing nature into decision-making'.

Policy Reform on the Qualification Pathway of Internationally Educated Nurses in Greenland and Its Relationship With the Danish System: A Qualitative Discourse Analysis

The nursing profession in Greenland, particularly in rural and remote areas, faces challenges due to geographical limitation and a lack of interdisciplinary collaboration. The registration process and status of internationally educated nurses (IENs) in Greenland are unclear. This article aimed to analyze existing policies and propose recommendations for an independent registration process for IENs in Greenland. A qualitative discourse analysis was used to critically discuss existing policies and regulations governing nursing registration in Greenland. Relevant legislation, government reports, and official documents were reviewed. Legislative regulations protect the title of registered nurse in both Greenland and Denmark. To work in Greenland, an IEN must have a residence permit. With recent health agreements between Greenland and Denmark, both countries have streamlined the permit acquisition process for foreign healthcare professionals, making it more accessible. However, the process of acquiring a license to work as a registered nurse for IENs lacks clarity. Policy reform is needed to establish a group of diverse nurse experts under the National Board of Health responsible for the assessment and registration of IEN qualifications. There is also a need for a bridging education program or national licensure examination which could facilitate faster IEN recognition. Mutual recognition of nurse licenses between Greenland and Denmark should be established to ensure efficient healthcare delivery and maintain professional standards. Embracing IENs can address nursing shortages and improve healthcare services in Greenland.

Government-Nongovernmental Organization (NGO) Collaboration in Macao's COVID-19 Vaccine Promotion: Social Media Case Study

BACKGROUND

The COVID-19 pandemic triggered unprecedented global vaccination efforts, with social media being a popular tool for vaccine promotion.

OBJECTIVE

This study probes into Macao's COVID-19 vaccine communication dynamics, with a focus on the multifaceted impacts of government agendas on social media.

METHODS

We scrutinized 22,986 vaccine-related Facebook posts from January 2020 to August 2022 in Macao. Using automated content analysis and advanced statistical methods, we unveiled intricate agenda dynamics between government and nongovernment entities.

RESULTS

"Vaccine importance" and "COVID-19 risk" were the most prominent topics co-occurring in the overall vaccine communication. The government tended to emphasize "COVID-19 risk" and "vaccine effectiveness," while regular users prioritized vaccine safety and distribution, indicating a discrepancy in these agendas. Nonetheless, the government has limited impact on regular users in the aspects of vaccine importance, accessibility, affordability, and trust in experts. The agendas of government and nongovernment users intertwined, illustrating complex interactions.

CONCLUSIONS

This study reveals the influence of government agendas on public discourse, impacting environmental awareness, public health education, and the social dynamics of inclusive communication during health crises. Inclusive strategies, accommodating public concerns, and involving diverse stakeholders are paramount for effective social media communication during health crises.

Built for Advocacy

Advocacy is a lever for positive change and is most effective and satisfying when used proactively. It is also one of nurses' superpowers and desperately needed outside health care settings, especially in the policy arenas of local, state, and federal government. Despite nurses' being the largest segment of the health care workforce, their voices are often missing from crucial conversations about access to care, health inequities, and upstream problems affecting people's health. Short of being the policy makers themselves, the best way for nurses to affect these decisions is to build and use influence with policy makers. There are concrete steps that nurses can take to grab a seat at the table.

Get the win-win: Sustainable circular model of 'generation-value-technology' of industrial solid waste management

The management of industrial solid waste (ISW) and promoting sustainable circular development of the industrial economy is an urgent priority today. Therefore, this article constructs a sustainable circular model of 'generation-value-technology' of ISW management through the lens of industrial added value (IAV) and technology level. Also, the importance of the role of government is considered in the model. Based on actual data of China, this article simulates the future trend of the model using a system dynamics approach. The chief findings of the study are as follows: (1) under the current policy, China's future industrialization is increasing and the technological level of industrial enterprises is rising, but this is accompanied by a climb in ISW generation. (2) The win-win situation of ISW decrease and IAV increase can be achieved through enhanced information disclosure, technology innovation and government incentives. (3) Government subsidy should be oriented towards supporting technology innovation in industrial enterprises while reducing the proportion of incentives for ISW management results. Based on the results, this study proposes targeted policy implications for government and industrial enterprises.

Harmonizing government responses to the COVID-19 pandemic

Public health and safety measures (PHSM) made in response to the COVID-19 pandemic have been singular, rapid, and profuse compared to the content, speed, and volume of normal policy-making. Not only can they have a profound effect on the spread of the disease, but they may also have multitudinous secondary effects, in both the social and natural worlds. Unfortunately, despite the best efforts by numerous research groups, existing data on COVID-19 PHSM only partially captures their full geographical scale and policy scope for any significant duration of time. This paper introduces our effort to harmonize data from the eight largest such efforts for policies made before September 21, 2021 into the taxonomy developed by the CoronaNet Research Project in order to respond to the need for comprehensive, high quality COVID-19 data. In doing so, we present a comprehensive comparative analysis of existing data from different COVID-19 PHSM datasets, introduce our novel methodology for harmonizing COVID-19 PHSM data, and provide a clear-eyed assessment of the pros and cons of our efforts.

Affecting change as a clinical academic

Clinical academics can effectively advocate for cultural and policy transformations to improve health outcomes; but where do you begin? We present a case study of academics from Melanoma Institute Australia (MIA) who are engaging with the public, media, and policymakers to affect meaningful change in melanoma skin cancer.

Modelling six sustainable development transformations in Australia and their accelerators, impediments, enablers, and interlinkages

There is an urgent need to accelerate progress on the Sustainable Development Goals (SDGs) and recent research has identified six critical transformations. It is important to demonstrate how these transformations could be practically accelerated in a national context and what their combined effects would be. Here we bridge national systems modelling with transformation storylines to provide an analysis of a Six Transformations Pathway for Australia. We explore important policies to accelerate progress, synergies and trade-offs, and conditions that determine policy success. We find that implementing policy packages to accelerate each transformation would boost performance on the SDGs by 2030 (+23% above the baseline). Policymakers can maximize transformation synergies through investments in energy decarbonization, resilience, social protection, and sustainable food systems, while managing trade-offs for income and employment. To overcome resistance to transformations, ambitious policy action will need to be underpinned by technological, social, and political enabling conditions.

Development of New Stringency Indices for Nonpharmacological Social Distancing Policies Implemented in Korea During the COVID-19 Pandemic: Random Forest Approach

BACKGROUND

In the absence of an effective treatment method or vaccine, the outbreak of the COVID-19 pandemic elicited a wide range of unprecedented restriction policies aimed at mitigating and suppressing the spread of the SARS-CoV-2 virus. These policies and their Stringency Index (SI) of more than 160 countries were systematically recorded in the Oxford COVID-19 Government Response Tracker (OxCGRT) data set. The SI is a summary measure of the overall strictness of these policies. However, the OxCGRT SI may not fully reflect the stringency levels of the restriction policies implemented in Korea. Korea implemented 33 COVID-19 restriction policies targeting 4 areas: public facilities, public events, social gatherings, and religious gatherings.

OBJECTIVE

This study aims to develop new Korea Stringency Indices (KSIs) that reflect the stringency levels of Korea's restriction policies better and to determine which government-implemented policies were most effective in managing the COVID-19 pandemic in Korea.

METHODS

The random forest method was used to calculate the new KSIs using feature importance values and determine their effectiveness in managing daily COVID-19 confirmed cases. Five analysis periods were considered, including November 01, 2020, to January 20, 2021 (Period 1), January 20, 2021, to June 27, 2021 (Period 2), November 01, 2020, to June 27, 2021 (Period 3), June 27, 2021, to November 01, 2021 (Period 4), and November 01, 2021, to April 24, 2022 (Period 5).

RESULTS

Among the KSIs, public facilities in period 4, public events in period 2, religious gatherings in periods 1 and 3, and social gatherings in period 5 had the highest importance. Among the public facilities, policies associated with operation hour restrictions in cinemas, restaurants, PC rooms, indoor sports facilities, karaoke, coffee shops, night entertainment facilities, and baths or saunas had the highest importance across all analysis periods. Strong positive correlations were observed between daily confirmed cases and public facilities, religious gatherings, and public events in period 1 of the pandemic. From then, weaker and negative correlations were observed in the remaining analysis periods. The comparison with the OxCGRT SI showed that the SI had a relatively lower feature importance and correlation with daily confirmed cases than the proposed KSIs, making KSIs more effective than SI.

CONCLUSIONS

Restriction policies targeting public facilities were the most effective among the policies analyzed. In addition, different periods call for the enforcement of different policies given their effectiveness varies during the pandemic.

A comprehensive dataset of U.S. federal laws (1789-2022)

U.S. federal laws figure importantly in many research projects in political science, law, sociology, economics, and other disciplines. Despite their prominence, there is no authoritative, current, and comprehensive dataset of U.S. federal laws. In part, this is because such laws have been enacted over hundreds of years, resulting in a complicated patchwork of documents published in numerous and inconsistent formats. As a simplification, many scholars have relied upon selective lists of major legislative enactments or complete lists of relatively recent enactments. Here, I report on an effort to transparently and reproducibly assemble a complete database of US laws and their revision histories by combining data from HeinOnline, the Governmental Printing Office, and the National Archives and Records Administration. The result is a database of 49,746 laws spanning 1789 to 2022.

American local government elections database

The study of urban and local politics in the United States has long been hindered by a lack of centralized sources of election data. We introduce a new database of about 78,000 candidates in 57,000 electoral contests that encompasses races for seven distinct local political offices in most medium and large cities and counties in the U.S. over the last three decades. This is the most comprehensive publicly-available source of information on local elections across the country. We provide partisan and demographic information about candidates in these races as well as electoral outcomes. This new database will facilitate a myriad of new research on representation and elections in local governments.

Towards understanding policy design through text-as-data approaches: The policy design annotations (POLIANNA) dataset

Despite the importance of ambitious policy action for addressing climate change, large and systematic assessments of public policies and their design are lacking as analysing text manually is labour-intensive and costly. POLIANNA is a dataset of policy texts from the European Union (EU) that are annotated based on theoretical concepts of policy design, which can be used to develop supervised machine learning approaches for scaling policy analysis. The dataset consists of 20,577 annotated spans, drawn from 18 EU climate change mitigation and renewable energy policies. We developed a novel coding scheme translating existing taxonomies of policy design elements to a method for annotating text spans that consist of one or several words. Here, we provide the coding scheme, a description of the annotated corpus, and an analysis of inter-annotator agreement, and discuss potential applications. As understanding policy texts is still difficult for current text-processing algorithms, we envision this database to be used for building tools that help with manual coding of policy texts by automatically proposing paragraphs containing relevant information.

Psychological screening, providing social security or strengthening training? How can government and labor unions protect the mental health of young employees

As the mental health problems of young employees become more and more prominent, the government and labor unions need to take measures to protect the mental health of young employees. Considering that the main mental health safeguard measures are divided into psychological screening, providing social security and strengthening training, this article constructs a differential game model under these three modes. The balanced efforts and social benefits of the government and labor unions under the three modes are obtained, and the applicable conditions of various mental health protection modes are compared. The results show that if the government pays a lower cost, the government gets the highest economic benefit under the training mode, followed by the security mode, and the government gets the lowest economic benefit under the psychological screening mode. If the reputation of the labor unions improved by its efforts is low, the equilibrium benefits of the labor unions under psychological screening and providing security are the same, and greater than the equilibrium benefits under the intensive training mode. If the labor unions have a higher reputation enhanced by its efforts, the balance return of the labor unions under the guarantee mode is the highest, followed by the balance return under the intensive training mode, and the balance return of the labor unions under the psychological screening mode is the lowest.

Bridging the gap: Survey highlights challenges and solutions in outreach and identification of people with inherited bleeding disorders

INTRODUCTION

Inherited bleeding disorders (IBD) are genetic conditions that affect blood clotting, leading to complications such as prolonged or spontaneous bleeding into muscles or joints. Early identification and treatment are crucial to prevent complications and improve outcomes. However, effective patient outreach and identification programs for IBD face significant challenges globally.

AIM

This study aimed to identify successful patient outreach initiatives for IBD, barriers encountered during implementation, and approaches used to overcome them.

METHODS

The World Federation of Haemophilia (WFH) conducted a survey of its national member organizations and other patient associations, totalling 153 organizations, to identify common strategies, barriers to their implementation, and solutions for outreach and the identification of people with IBD. The survey consisted of both closed-ended and open-ended questions, and the data were analysed using descriptive statistics and thematic analysis.

RESULTS

Common challenges included resource and sustainability-related aspects such as financial constraints, limited lab equipment for diagnosis, and inadequate government commitment. Significant barriers also encompassed physical/geographical challenges like difficulty accessing remote areas, and inadequate logistical support and transportation. Seven themes emerged to enhance patient outreach: resource mobilization; awareness-raising and advocacy; knowledge and capacity building; collaboration and partnership; decentralization of services; improved logistical support and infrastructure; utilization of technology and innovation; and financial aid and incentives.

CONCLUSION

Multistakeholder collaboration, coupled with secured government commitment, is crucial for improving global outreach, diagnosis rates, and access to care for individuals with IBD. Customized outreach programs should consider regional contexts, financial constraints, and prioritize innovation.

Workplace Violence Against Nurses in Canada: A Legal Analysis

Workplace violence against nurses is a significant global occupational health problem, with incidents of violence increasing in frequency since the COVID-19 pandemic began. In this article, we provide a review of recent legislative amendments meant to bolster workplace safety in health care in Canada, analyze legal cases where nurses were the victims of violence, and discuss what these legal reforms and decisions reveal about how nurses' work is treated within the Canadian legal system. Under criminal law, the limited number of cases we could find with oral or written sentencing decisions show that, historically, the fact a victim was a nurse was not always considered an aggravating factor on sentencing. Recent legislative amendments make this a specified aggravating factor and it is important to track the impact of these amendments when judges exercise their discretion in sentencing. Under employment law, it appears that, despite the government's efforts to increase the deterrence factor under legislation with significantly increased fines for employers who fail to protect their employees from injury, courts remain reluctant to impose such sanctions. In these cases, it is also important to track the impact of harsher penalties. We conclude that combating the widespread normalization of workplace violence in health care, and specifically against nurses, is acutely needed to help ensure that these ongoing legal reforms aimed at improving the safety of health workers are effective.

Government Relations and Interventional Radiology

Health care policy in the United States is made by nonphysician lawmakers and government employees. Through advocacy and lobbying, physicians have an opportunity to be involved in the process. Interventional radiologists (IRs) are the experts on issues related to IR. Government relation offers IRs the opportunity to engage with members of Congress, officials in Federal and State agencies, and State legislators to inform and influence their decision making. The Society of Interventional Radiology PAC (SIRPAC) is the only PAC to represent the interests of interventional radiology. Increased contributions to SIRPAC are essential to be sure that the voice of IR is heard.

Experts' assessments of migration scenarios between the Middle East & North Africa and Europe

We describe data collected among 138 migration experts about the repercussions of scenarios of social change on migration between the Middle East & North Africa and Europe, during the period 2021-2030. Scenarios include changes in the cultural, demographic, economic, and political determinants of migration in sending and receiving countries. Assessments focus on the change in the number of family, work, and return migrants, the number of refugees, and the likelihood of achieving safe, orderly, and regular migration. Experts were at the moment of the survey active in European research centers or European (supra-) national governmental or civil society organizations. The survey features a factorial design, which allows for identifying a causal relationship between the experts' assessments and the scenarios of social change. Our data may be used to estimate projection models of future migration flows, map out what experts consider as critical migration issues for the region, and identify areas of agreement or disagreement between them. As such, our dataset may illuminate decision-making regarding migration policies in Europe and beyond.

Editors' Commentary on the 2023 ESH Management of Arterial Hypertension Guidelines

Clinical practice guidelines are ideally suited to the provision of advice on the prevention, diagnosis, evaluation, and management of high blood pressure (BP). The recently published European Society of Hypertension (ESH) 2023 ESH Guidelines for the management of arterial hypertension is the latest in a long series of high BP clinical practice guidelines. It closely resembles the 2018 European Society of Cardiology/ESH guidelines, with incremental rather than major changes. Although the ESH guidelines are primarily written for European clinicians and public health workers, there is a high degree of concordance between its recommendations and those in the other major BP guidelines. Despite the large number of national and international BP guidelines around the world, general population surveys demonstrate that BP guidelines are not being well implemented in any part of the world. The level of BP, which is the basis for diagnosis and management, continues to be poorly measured in routine clinical practice and control of hypertension remains suboptimal, even to a conservative BP target such as a systolic/diastolic BP <140/90 mm Hg. BP guidelines need to focus much more on implementation of recommendations for accurate diagnosis and strategies for improved control in those being treated for hypertension. An evolving body of implementation science can assist in meeting this goal. Given the enormous health, social, and financial burden of high BP, better diagnosis and management should be an imperative for clinicians, government, and others responsible for the provision of health care services. Hopefully, the 2023 ESH will help enable this.

A study on prevalence and risk factors of depression among adolescent girls studying in government and private schools-A comparative study

Background

The prevalence of depression among school-going adolescent girls in India is about 40%. Adolescent girls attending private and government-run schools in South India have vastly different sociodemographic backgrounds and school environments. Assessing the associated risk factors for depression will help in designing appropriate preventive strategies.

Objective

To evaluate the prevalence of depression among school-going adolescent girls and the associated risk factors among government and private school students.

Methods

The cross-sectional comparative study was conducted in two private and two government-run schools in Tamil Nadu. A semi-structured questionnaire and 11-item Kutcher Adolescent Depression Scale were administered to female students belonging to grades eight, nine, and ten. Differences in the prevalence of depression and the familial, social, and behavioral risk factors between private and government school students were measured and analyzed.

Results

The prevalence of depression among our study population is 23.8%. An adolescent girl studying in a private school has a 4.67 times higher chance of being depressed as compared to her counterpart in a government school. Stress due to higher academic expectations, peer pressure, disagreement with friends, excess smartphone usage, and family discord are associated factors in private school students, and family discord and chronic illness among family members were associated risk factors for depression in government school students.

Conclusion

There is a wide disparity in the prevalence of depression and associated factors among private and government school-going adolescent girls. The intervention program for depression has to be addressed differently according to the type of school.

Capacity needs assessment and challenges for multisectoral implementation of nutrition in Burkina Faso: A guide for the formulation of a capacity development plan

INTRODUCTION

Achieving nutritional goals depends on individual, organisational and environmental capacities. The aim of this study was to analyse and identify capacity gaps among the coordination platforms and networks, and the key technical institutions related to nutrition in Burkina Faso for a capacity development plan formulation.

METHODS

Using the new Nutrition Capacity Framework developed by the United Nations Network, information were collected using the Nutrition Stakeholder Mapping and Analysis tool, and the Checklist for Capacity Areas. Capacity needs were analysed in terms of Human resource and infrastructure, functional, organisational, coordination and partnership, and financial and resource mobilisation.

RESULTS

Limited human resource capacity in nutrition was highlighted in most cases by the structures, and the nutrition coordination structure and more than 4/5 of the technical structures are faced with the unavailability of working materials, tools and basic Internet connection. Only 10 among the 30 structures have a unit or service for exchange on nutrition, and only three of them have integrated nutrition actions. Shortfalls were noted in terms of functional, facilitation, communication and advocacy skills, as well as a weak diversification of resource mobilisation strategies.

CONCLUSION

The use of the analytical framework helped to identify the gaps and to propose paths for capacity development. Efforts need to be strengthened, intensified, coordinated, monitored, evaluated and funded.

Factors limiting US public health emergency authority during COVID-19

Since the onset of the COVID-19 pandemic, many states in the United States have limited emergency public health authority. These limits could undermine public health efforts and raise concerns about how states and localities will prevent and respond to future public health challenges. We examined which of the 50 US states passed laws to set limits on public health emergency authority in 2021 through 2022, and their relationship to COVID-19 death rates. We explored five government characteristics: COVID-19 policy response, political partisanship (Republican control), legislative professionalism, local government autonomy, and broader non-COVID-19 related preemptions. Results of T-tests and a Generalised Structural Equation Model show that states with unified Republican control had greater odds of limiting emergency public health authority of the state executive, state governor, state health official, and local health officials. Limits of emergency public health authority were associated with a higher COVID-19 death rate. We found that states setting limits on emergency authority are primarily related to politicisation and political competition between state executives/governors and legislatures, rather than pushback against the COVID-19 public health response. Limiting emergency public health authority is less common in states with more professional state legislatures. Structural changes related to party control, legislative professionalism, and local autonomy may facilitate public health authority.

Analysis of the factors influencing the effectiveness of local government's purchase of older adults care services - a grounded theory study based on typical cases

Background

Population aging is a basic national condition in China at present and for a long time to come, forcing the country to accelerate the pace of building its public older adults care system. The government's purchase of older adults care services has become an effective way to make up for the lack of the family's older adults care function, to which the Chinese government attaches particular importance. The article selects 11 typical cases from the excellent case base released by the Chinese Ministry of Civil Affairs officials in 2022 to study the influencing factors of the effect of local government purchase of older adults care service supply.

Methods

NVivo data analysis tools have significant advantages in retrieving, analyzing and coding data more efficiently and accurately, which helps to construct theoretical propositions and formulate hypotheses to be tested in qualitative research. The study intends to adopt the grounded theory approach to analyze the text with the help of NVivo12 software, to condense the practice mechanism of local governments' purchasing of older adults care services and to construct a relational model.

Results

Taking "the supply effect of local government purchasing older adults services" as the main logic line, the article summarizes the four main influencing factors of the supply effect of government purchasing older adults services: the real demand of the society, the government's power and responsibility system, the government's governance ability, and the society's acceptance ability.

Conclusion

The sense of gain, happiness and security of the older adults group is the starting point and landing point of the older adults service policy formulation and implementation. Policy guidance and decision-making have an important impact on the quality of the supply of older adults care services and the development of the older adults care services industry. Clarifying the direction of policy guidance, reflecting the comprehensive efficiency of government governance and utilizing the professional advantages of social forces, is the key to improving the effectiveness of the government's purchase of older adults care services.

Results from Estonia's 2022 Report Card on Physical Activity for Children and Youth: Research Gaps and Five Key Messages and Actions to Follow

The aim of this article is to summarize the results of the 2022 Estonian Physical Activity Report Card across 10 indicators based on available scientific data and national databases, and, additionally, to compare the current results with previous Report Card results. A national expert panel, consisting of research and policy experts, identified the available sources and synthesized as well as graded relevant data related to the physical activity (PA) of Estonian children and youth. Grade B was assigned to Organized Sports and Physical Activity (B-), Community and Environment (B+), and Government (B). Grade C was assigned to Overall Physical Activity (C+), Physical Fitness (C+), Family and Peers (C-), and School (C+). The lowest grade, D, was assigned to Active Play (D), Active Transportation (D+), and Sedentary Behaviors (D-). In Estonia, the participation rate in organized sport is relatively high, and government in addition to community support seem to be at a relatively good level. However, a relatively high number of children and youth did not meet the current PA guidelines, and the levels of sedentary behavior and screen time were very high. The PA of children and youth should be a cross-disciplinary priority, and focus should be put on developing schoolyards and outdoor breaks, varied and easily accessible organized sport, the use of active transportation, and the implementation of physical education that supports leisure time activities.

SPRC19: A Database of State Policy Responses to COVID-19 in the United States

SPRC19 is a new database that seeks to capture a wide range of state policy actions in response to COVID-19 in the United States. Since March 2020 we have monitored state governments' and multi-state associations' websites for executive orders, agency rules, new legislation, and court decisions. We categorize each policy action into one of 206 distinct policies, then document the branch of government, source document, announcement date, implementation date, and expiration date (if applicable). We also record whether the action represents the introduction of a new policy or the expansion or contraction of an existing policy. The current release of SPRC19, v3.0, captures over 13,000 distinct policy actions through April 2020, which constitutes thousands more actions than similar resources over the same time period.

Suspecting the Figures: What Church Leaders Think About Government's Commitment to Combating COVID-19 in Nigeria

Public trust in government can significantly determine the outcome of health policies in any society. Hence, studies have been gauging peoples' level of trust in their governments' commitment and capacity to win the fight against COVID-19. However, these studies have omitted religious leaders. This is despite the fact that religious leaders play key roles in the area of health in many societies. The present study, therefore, explored the opinions church leaders have about the credibility of the COVID-19 statistics and other government responses in Nigeria. Data were collected through semi-structured interviews with 18 church leaders drawn from Anglican, Catholic, and Pentecostal churches in Nigeria. A descriptive narrative approach was employed in the thematic organization and analysis of data. Findings show that only one participant expressed confidence in the credibility of the COVID-19 statistics and other government's responses. The rest, with the exception of one participant who was uncertain, was distributed between those who believe the statistics and other government efforts are exaggerated and those who believe they are false. The study also found that denominational affiliation mattered with respect to the perceptions about the credibility of the COVID-19 statistics and other government responses. Implications of findings for policy and research are discussed.

Assessing the associated medical, legal, and social issues in medical tourism and its implications for Nigeria

Medical tourism is thriving in Nigeria among both elites and non-elites with over $1 billion annual expenditure on medical tourism. Inadequate healthcare infrastructure caused by economic problems, corruption and low budgetary allocation to the country's health sector, and lack of trust in the country's healthcare systems to handle complex medical procedures have contributed to this trend. This article discusses the trend of medical tourism in Nigeria and the associated medical, legal, and social issues in medical tourism generally, relying on relevant literature. The paper concludes that medical tourism is not inherently dangerous; however, unequal economic and power status may influence the quality of hospitals where patients receive treatment and the quality of treatment received. This unequal power and economic status may also determine justice in cases of substandard treatment in foreign hospitals. The study recommends that the Nigerian government should improve healthcare systems in the country to reverse the trend of medical tourism and to reduce the financial burden that medical tourism exerts on average Nigerians who need a high level of care but cannot access it in their country. It is also recommended that a regulatory framework that ensures protection from substandard hospitals and justice for Nigerians who fall victim to substandard care abroad must be put in place by the Nigerian government. Relevant health stakeholders should also continue to sensitize the public about the complications that may be associated with some medical procedures sought outside Nigeria especially cosmetic surgery which may result in follow-up challenges.

Impact of Superiors' Ethical Leadership on Subordinates' Unethical Pro-Organizational Behavior: Mediating Effects of Followership

This study examined the impact of superiors' ethical leadership on subordinates' unethical pro-organizational behavior (UPB) and the mediating effects of followership. The research subjects were officials from the ten central departments of the South Korean government, and a cross-sectional survey was conducted among them. Overall, 404 questionnaires were used in the empirical analysis. Multiple regression analysis and Hayes Process Macro were used to validate the research hypotheses, which examined the relationship among ethical leadership, followership, and UPB. The results are as follows: First, the relationship between ethical leadership and followership was statistically significant. Second, the study showed that followership had a statistically significant effect on UPB but not ethical leadership. Third, testing the hypotheses regarding the mediating effect of followership on the relationship between ethical leadership and UPB revealed statistically significant results. This study confirms that followership significantly influences UPB and suggests that ethical leadership is an important precedent factor of followership. The study concludes with the theoretical and practical implications of these findings, along with the study's limitations.

The Intersection of Media and Policy: A Case Study

From October 2008 through 2010, journalists Charles Ornstein and Tracey Weber produced for the Los Angeles Times and ProPublica a series of investigative reports on the performance of the California Board of Registered Nursing (BRN), finding that it took an average of 3.5 years to act on complaints of professional misconduct by registered nurses, including sexual assault of patients, substance use, and repeat medication errors that resulted in patients dying. In June 2009, Governor Arnold Schwarzenegger announced that he was firing members of the BRN. Its executive officer resigned shortly thereafter. This case study analyzes interviews with nine participants, including the journalists and individuals who were public and nurse members of the BRN in 2009. Four themes emerged: (1) There is a tension between what are perceived to be the public's interests versus nursing's interests; (2) Political naiveté about government and organizational culture can lead to the personalization of actions directed at institutions; (3) A sense of fatalism may be reinforced by organizational culture; and (4) The role and use of media in a free society may be obscured when one is the focus of investigative journalism. Nurses who seek to operate in the public sector must be grounded in the political realities of complex governmental forces that may appear to be illogical or personally offensive. Media, particularly news media, is a powerful tool for influencing these forces. Nurses should employ strategic approaches to the use of media in order to advance their voices as advocates for the public's interests.

Socioeconomic and Governance Factors Disentangle the Relationship between Temperature and Antimicrobial Resistance: A 10-Year Ecological Analysis of European Countries

Although previous studies showed that warmer temperatures may be associated with increased antimicrobial resistance (AMR) rates, unmeasured factors may explain the observed relationship. We conducted a ten-year ecological analysis to evaluate whether temperature change was associated with AMR across 30 European countries, considering predictors that can determine a geographical gradient. Using four data sources, we created a dataset of: annual temperature change (FAOSTAT database); AMR proportions for ten pathogen-antibiotic combinations (ECDC atlas); consumption of antibiotics for systemic use in the community (ESAC-Net database); population density, gross domestic product (GDP) per capita, and governance indicators (World Bank DataBank). Data were obtained for each country and year (2010-2019) and analyzed through multivariable models. We found evidence of a positive linear association between temperature change and AMR proportion across all countries, years, pathogens, and antibiotics (β = 0.140; 95%CI = 0.039; 0.241; p = 0.007), adjusting for the effect of covariates. However, when GDP per capita and the governance index were included in the multivariable model, temperature change was no longer associated with AMR. Instead, the main predictors were antibiotic consumption (β = 0.506; 95%CI = 0.366; 0.646; p < 0.001), population density (β = 0.143; 95%CI = 0.116; 0.170; p < 0.001), and the governance index (β = -1.043; 95%CI = -1.207; -0.879; p < 0.001). Ensuring the appropriate use of antibiotics and improving governance efficiency are the most effective ways of counteracting AMR. It is necessary to conduct further experimental studies and obtain more detailed data to investigate whether climate change affects AMR.

Economic costs of protecting islands from invasive alien species

Biological invasions represent a key threat to insular systems and have pronounced impacts across environments and economies. The ecological impacts have received substantial focus, but the socioeconomic impacts are poorly synthesized across spatial and temporal scales. We used the InvaCost database, the most comprehensive assessment of published economic costs of invasive species, to assess economic impacts on islands worldwide. We analyzed socioeconomic costs across differing expenditure types and examined temporal trends across islands that differ in their political geography-island nation states, overseas territories, and islands of continental countries. Over US$36 billion in total costs (including damages and management) has occurred on islands from 1965 to 2020 due to invasive species' impacts. Nation states incurred the greatest total and management costs, and islands of continental countries incurred costs of similar magnitude, both far higher than those in overseas territories. Damage-loss costs were significantly lower, but with qualitatively similar patterns across differing political geographies. The predominance of management spending differs from the pattern found for most countries examined and suggests important knowledge gaps in the extent of many damage-related socioeconomic impacts. Nation states spent the greatest proportion of their gross domestic products countering these costs, at least 1 order of magnitude higher than other locations. Most costs were borne by authorities and stakeholders, demonstrating the key role of governmental and nongovernmental bodies in addressing island invasions. Temporal trends revealed cost increases across all island types, potentially reflecting efforts to tackle invasive species at larger, more socially complex scales. Nevertheless, the already high total economic costs of island invasions substantiate the role of biosecurity in reducing and preventing invasive species arrivals to reduce strains on limited financial resources and avoid threats to sustainable development goals.

The Politics of Population Health

Policy Points Despite increased spending and consuming more health care services than any other country in the world, the United States global health rankings experience continued decline, including worsening performance in life expectancy and mortality owing to lack of investment in and strategies on the upstream determinants of health. These determinants of health are found in our access to adequate, affordable, and nutritious food options; safe housing, blue and green spaces; reliable and safe transportation; education and literacy; opportunities for economic stability; and sanitation, among other important factors and all share a common root driver in the political determinants of health. Health systems are increasingly investing in programs and exerting influence over policies to address these upstream determinants of health, including population health management, however these programs will continue to be hindered without addressing the political determinants through government, voting, and policy. Although these investments are laudable, it is important to understand what gives rise to the social determinants of health and-more importantly-why have they disproportionately and detrimentally affected historically marginalized communities and vulnerable populations for so long? Deeply entrenched and pervasive throughout society, the political determinants of health are the fundamental instigators of these unjust and inequitable outcomes.

LocalView, a database of public meetings for the study of local politics and policy-making in the United States

Despite the fundamental importance of American local governments for service provision in areas like education and public health, local policy-making remains difficult and expensive to study at scale due to a lack of centralized data. This article introduces LOCALVIEW, the largest existing dataset of real-time local government public meetings-the central policy-making process in local government. In sum, the dataset currently covers 139,616 videos and their corresponding textual and audio transcripts of local government meetings publicly uploaded to YouTube-the world's largest public video-sharing website-from 1,012 places and 2,861 distinct governments across the United States between 2006-2022. The data are processed, downloaded, cleaned, and publicly disseminated (at localview.net ) for analysis across places and over time. We validate this dataset using a variety of methods and demonstrate how it can be used to map local governments' attention to policy areas of interest. Finally, we discuss how LOCALVIEW may be used by journalists, academics, and other users for understanding how local communities deliberate crucial policy questions on topics including climate change, public health, and immigration.

Need to Bring Family to the Heart of Healthcare as it is Home, not a Hospital, Where Healthcare Begins and Ends

Today the patients and their families are 'powerless' recipients of healthcare services. The healthcare services are siloed and fragmented and getting worse with an increasing array of specialists and subspecialists who "patch up" patients and send them back home. It is important for healthcare providers to become involved in the process of health promotion, prevention, and recovery. For successful implementation of this family-level care needs to be recognized and integrated into all policies, guidelines of the government, and healthcare providers reoriented through in-service and basic training.

How does government policy influence the employment and training of nurse practitioners and physician assistants? A realist analysis using qualitative interviews

AIMS

The aim of this study was to develop insights into how and why Dutch government policies on deployment and training of nurse practitioners and physician assistants have effect and under what circumstances.

DESIGN

A realist analysis using qualitative interviews.

METHODS

Data analysis of 50 semi-structured interviews conducted in 2019 with healthcare providers, sectoral and professional associations, and training coordinators. Stratified purposive and snowball sampling were used.

RESULTS

Policies stimulated employment and training of nurse practitioners and physician assistants by: (1) contributing to the familiarity of participants in the decision-making process in healthcare providers with and medical doctors' trust in these professions; (2) contributing to participants' motivation in employment and training; and (3) eliminating barriers perceived by medical doctors, managers and directors. The extent to which policies affected employment and training was largely determined by sectoral and organizational circumstances, such as healthcare demand and complexity, and decision-makers in healthcare providers (medical doctors or managers/directors).

CONCLUSION

Effectuating familiarity and trust among participants in the decision-making process is a crucial first step. Next, policymakers can motivate participants and lower their perceived barriers by extending the scope of practice, creating reimbursement opportunities and contributing to training costs. Theoretical insights into nurse practitioner and physician assistant employment and training have been refined.

IMPACT

The findings highlight how governments, health insurers, sectoral and professional associations, departments, councils, healthcare providers and professionals can facilitate and support nurse practitioner and physician assistant employment and training by contributing to familiarity, trust and motivation, and by clearing perceived barriers.

Making connections: the scientific impact and mentoring legacy of Dr. John E. Moulder

PURPOSE

The intent of this mini review is to pay homage to Dr. John E. Moulder's long and successful career in radiation science with the Medical College of Wisconsin. This effort will be done from the perspective of his history of U.S. Government funding for research into the biological pathways involved in radiation-induced normal tissue injuries, especially damage to the kidneys and heart, and pharmacological interventions. In addition, the impact of his steady guidance and leadership in the mentoring of junior scientists, and the development of meaningful collaborations with other researchers will be highlighted.

CONCLUSION

Dr. John E. Moulder's contributions to the field of radiation research, through his strong character and reputation, his consistent and dedicated commitment to his colleagues and students, and his significant scientific advances, have been critical to moving the science forward, and will not be forgotten by those who knew him personally or through publications documenting his important work.

National Institutes of Health research project grant inflation 1998 to 2021

We analyzed changes in total costs for National Institutes of Health (NIH) awarded Research Project Grants (RPGs) issued from fiscal years (FYs) 1998 to 2021 . Costs are measured in 'nominal' terms, meaning exactly as stated, or in 'real' terms, meaning after adjustment for inflation. The NIH uses a data-driven price index - the Biomedical Research and Development Price Index (BRDPI) - to account for inflation, enabling assessment of changes in real (that is, BRDPI-adjusted) costs over time. The BRDPI was higher than the general inflation rate from FY1998 until FY2012; since then the BRDPI has been similar to the general inflation rate likely due to caps on senior faculty salary support. Despite increases in nominal costs, recent years have seen increases in the absolute numbers of RPG and R01 awards. Real average and median RPG costs increased during the NIH-doubling (FY1998 to FY2003), decreased after the doubling and have remained relatively stable since. Of note, though, the degree of variation of RPG costs has changed over time, with more marked extremes observed on both higher and lower levels of cost. On both ends of the cost spectrum, the agency is funding a greater proportion of solicited projects, with nearly half of RPG money going toward solicited projects. After adjusting for confounders, we find no independent association of time with BRDPI-adjusted costs; in other words, changes in real costs are largely explained by changes in the composition of the NIH-grant portfolio.

A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups

Most governments have enacted physical or social distancing measures to control COVID-19 transmission. Yet little is known about the socio-economic trade-offs of these measures, especially for vulnerable populations, who are exposed to increased risks and are susceptible to adverse health outcomes. To examine the impacts of physical distancing measures on the most vulnerable in society, this scoping review screened 39,816 records and synthesised results from 265 studies worldwide documenting the negative impacts of physical distancing on older people, children/students, low-income populations, migrant workers, people in prison, people with disabilities, sex workers, victims of domestic violence, refugees, ethnic minorities, and people from sexual and gender minorities. We show that prolonged loneliness, mental distress, unemployment, income loss, food insecurity, widened inequality and disruption of access to social support and health services were unintended consequences of physical distancing that impacted these vulnerable groups and highlight that physical distancing measures exacerbated the vulnerabilities of different vulnerable populations.

Emergency risk communication and sensemaking during smoke events: A survey of practitioners

Emergency risk communication (ERC) for smoke emitted from major fires continues to challenge governments. During these events, practitioners (including scientific, communication, and emergency response government staff) are tasked with quickly making sense of the public health risks and the communication options available. Practitioners' sensemaking-the process of creating meaning from information about an unfolding emergency-is key to effective ERC. This article identifies the factors that ERC practitioners consider the most important to their sensemaking for smoke events. A survey of practitioners (n = 86) was conducted to elicit their views on the level of importance of 22 different factors (individual, organizational, and contextual) on their sensemaking. The results indicate that the majority of the factors tested are very important to practitioners. This finding likely reflects the multidimensional nature of emergency smoke events and provides evidence as to why practitioners are challenged when trying to make sense of emergency situations. Despite multiple factors being considered very important to practitioners, the time-limited nature of emergencies means that practitioners will inevitability be forced to prioritize in their sensemaking efforts. Our results also provide insight into practitioners' prioritization of different information sources. Specifically, practitioners prioritize their own knowledge and the knowledge of other practitioners. The two most important factors were information from other incident management stakeholders and the practitioners' past experience. Other information, including community-based and academic knowledge, appear to be of lower priority for practitioners. Based on the study results, recommendations for practice and future research are discussed.

Strengthening policies and structures to combat illicit tobacco trade in the Philippines

The Philippines has been seeing an increase in illicit tobacco trade in recent years, undermining the impacts of legal measures such as tobacco products' taxation and regulation due to circumvention of established avenues and costing the government its revenue. Currently, the country has twelve policies related to the prevention of illicit tobacco trade with gaps identified in its lack of licensing systems for tobacco retailers and policies on law enforcement cooperation, which manifests in the country being fully compliant to only 5 of the 16 articles under the World Health Organization's Illicit Tobacco Trade Protocol. It is recommended that the country establish a national agency or framework specifically for illicit tobacco trade to address its gaps under Tracking and Tracing, Due Diligence, and Unlawful Conduct.

Structural competency in New Mexico: Moving outside of medical education

ABSTRACTIn 2019, the Doña Ana Wellness Institute (DAWI), Doña Ana County, New Mexico's health council, sponsored two trainings in structural competency by the Structural Competency Working Group. One focused on health care professionals and learners; the other focused on government, non-profit organisations, and elected officials. DAWI and New Mexico Human Services Department (HSD) representatives attended the trainings and identified the structural competency model as useful for the health equity work both groups were already engaging. These trainings provided the foundation for DAWI and HSD to develop additional trainings, programmes, and curricula founded on structural competency and focused on supporting health equity work.This article describes how DAWI and HSD used the structural competency framework to deepen our work, including how we have expanded the concept beyond its original orientation to support strategic planning, improve communication, and build structurally competent communities. We illustrate how the framework strengthened our existing community and state work and how we adapted the model to better fit our work. Adaptations included changes in language, the use of the lived experiences of organisation members as a foundation for structural competency education, and a recognition that policy work happens at multiple levels and in multiple ways for organisations.

Important role of the government in reducing pesticide use and risk sustainably in Thailand: Current situation and recommendations

Agriculture is an important aspect of Thailand's GDP and development. It ranks as the 8th largest exporter in the world, however, pesticide use associated with the agriculture is ranked 18th in the world and 5th in Asia. Previous studies have clearly stated that pesticides are a threat to human health and the environment. The government is now making efforts to address pesticide use and the health impacts of pesticide use, however, these efforts are still in need of completion. This paper aims to summarize: (1) the current situation with regard to pesticide use in Thailand; (2) the current situation with regard to pesticide poisoning in Thailand; and (3) important role of government in reducing pesticide use and risk sustainably in Thailand: current situation and recommendations. This article suggests that government is a significant driver for reducing pesticide use and risk sustainably and the establishment of push and pull policies, legislation, and strategies. The government needs to strictly adhere to international conventions. Introducing a pesticide tax is essential to reduce redundant pesticide use. Updating of the current act, specific regulations with regard to pesticides and strict enforcement are urgently required. Licensing pesticide applicators should be implemented continuously. Promotion of alternative pest management is needed by supportive production inputs, technology, and markets as well as the development of a monitoring and certification system. Educating consumers on how to choose safe agricultural products and reduce risk from pesticide residues in the products is also necessary. All approaches should be implemented simultaneously and instantly. Importantly, the government needs to cooperate with agricultural sectors, health and environmental sectors, private sectors, as well as food industries to tackle complicate issues in a sustainable manner and lower pesticide use and risk sustainably in Thailand.

Worldwide Surveillance Actions and Initiatives of Drinking Water Quality: A Scoping Review

This study identified and mapped worldwide surveillance actions and initiatives of drinking water quality implemented by government agencies and public health services. The scoping review was conducted between July 2021 and August 2022 based on the Joanna Briggs Institute method. The search was performed in relevant databases and gray literature; 49 studies were retrieved. Quantitative variables were presented as absolute and relative frequencies, while qualitative variables were analyzed using the IRaMuTeQ software. The actions developed worldwide and their impacts and results generated four thematic classes: (1) assessment of coverage, accessibility, quantity, and drinking water quality in routine and emergency situations; (2) analysis of physical-chemical and microbiological parameters in public supply networks or alternative water supply solutions; (3) identification of household water contamination, communication, and education with the community; (4) and investigation of water-borne disease outbreaks. Preliminary results were shared with stakeholders to favor knowledge dissemination.

Quality Standards in State Programs Permitting Cannabis for Medical Uses

Currently in the United States, there exists a patchwork of state-level laws and regulations surrounding cannabis use. Although cannabis (excluding hemp under the Agricultural Improvement Act of 2018, Public Law 115-334) is illegal at the federal level and is not FDA (U.S. Food and Drug Administration) approved for any indication, many states allow patients with qualifying conditions to register for their medical cannabis program (MCP). To better understand the quality of cannabis found in these programs, we collected laws, regulations, and guidance documents available on public state-run websites and compared them with current good manufacturing practices (CGMPs) applicable to finished drug products. CGMPs for human drugs contain minimum requirements for the methods, facilities, and controls used in manufacturing, processing, and packaging of a drug product to assure it is safe for use. Such a comparison will aid the development of consistent quality standards that could, in turn, improve the quality of a wide range of cannabis medical products in development that may be sold in the United States. States may likewise choose to have the cannabis and cannabis-derived products that fall within their MCP to follow quality-focused guidelines, such as those listed in CGMPs, to ensure the quality of these products and promote public health. This study further solidifies the need for standardized testing protocols and methodologies to keep consumers safe.

Exposure to Misinformation, Risk Perception, and Confidence towards the Government as Factors Influencing Negative Attitudes towards COVID-19 Vaccination in Malaysia

INTRODUCTION

This study explored exposure to misinformation, COVID-19 risk perception, and confidence towards the government as predictors of negative attitudes toward the COVID-19 vaccine.

METHODS

A cross-sectional survey was carried out from 30 June to 30 August 2021 involving 775 respondents. The survey instrument for the questionnaire was an adaptation from various different studies consisting of five main variables: (1) misinformation about vaccination; (2) risk perception toward COVID-19; (3) attitudes toward the vaccination programme; (4) intention to get vaccinated; and (5) public confidence in the government in executing the vaccination programme.

RESULTS

The results of this study indicate that higher exposure to misinformation led to higher levels of negative attitudes toward the COVID-19 vaccine. When the perceived risk of COVID-19 infection was high, mistrust of vaccine benefits was low but there were also higher worries about the future effects of the vaccine. Confidence in the government was associated with lower negative attitudes toward the COVID-19 vaccine.

CONCLUSION

The results of this study may help develop an understanding of negative attitudes toward vaccinations in Malaysia and its contributing factors.