Policy Changes Research Articles

Ageing risks in four Asian Tigers: global health crisis and implications for productive welfare regimes

PurposeThis article focuses on the continuity and changes in the Productive Welfare Regimes and investigates how the COVID-19 pandemic and population ageing can influence the established systems in Hong Kong, South Korea, Singapore and Taiwan.Design/methodology/approachOur research is based on document review, investigating intricate situations with numerous aspects and providing an excellent opportunity for innovation and examining theoretical presumptions in welfare regime theory, as well as exploring the complicated policy trajectories that varies among cases.FindingsOur findings reveal that social policy responses to COVID-19 have been characterized by adopting the market-conforming role of social policy for the elderly. This is shown by many policy measures focusing on self-sufficiency and an active labour market, signalling that the COVID-19 pandemic and population ageing pressure here are viewed as an economic issue over social rights. The economic-first was adopted to maintain their proximity to the global economy as key sources of their social policy development. We can conclude by emphasizing that the responses to COVID-19 have exposed deficiencies in certain existing social policies. Yet, they have not been sufficient to catalyse substantial policy changes across domains where such change had not already been initiated, thus allowing welfare regimes to remain within productivist boundaries.Originality/valueThis study responds to the current debate on the welfare regime continuity and adaptation in East Asia and suggests a new perspective of policy process in the times of insecurity.

Impact of policy change on late-term abortion: a two-decade analysis.

Advances in ultrasound and molecular genetics have changed the field of late termination of pregnancy (LTOP), sparking ethical debates worldwide. In 2007, Israel updated its LTOP policies, requiring a 30% or higher probability of severe handicap for approval of LTOP after 24weeks' gestation. In this retrospective study, we compared LTOP indications and approval rates before (Group 1: 1998-2007) and after (Group 2: 2008-2021) this policy change. Shamir medical records from January 1, 1998 to December 31, 2021 were examined and yielded 4047 abortions, of which 248 were identified as LTOP preformed after 24weeks' gestation. These cases were then categorized into two groups. Data including maternal age, obstetric history, indications for abortion, diagnosis, week of termination, and genetic/sonographic findings were analyzed. The approval rates and indications pre- and post-policy change were compared. Group 1 (LTOP 1998-2007) comprised 95 cases (10.6%), and Group 2 (LTOP 2008-2021) was composed of 153 cases (4.9%). Fetal structural anomalies remained the dominant indication for both groups (67.4 and 65.3%, respectively), with a slight increase in confirmed genetic anomalies from 26.3% (Group 1) to 28% (Group 2). Our findings indicate a decrees in the proportion per year from 10.6 to 4.9% LTOP. Technological advances in genetic evaluation and sonography may have contributed to the early increased detection and decrees in cases reaching LTOP. These results highlight the importance of ongoing ethical reviews and adherence to strict protocols for early detection and termination before 24weeks' gestation.

International Medical Graduates and the Physician Workforce.

Physician shortages and the geographic maldistribution of general and specialist physicians impair health care delivery and worsen health inequity in the US. International medical graduates (IMGs) represent a potential solution given their ready supply. Despite extensive clinical experience, evidence of competence, and willingness to practice in underserved communities, IMGs experience multiple barriers to entry in the US, including the immigration process, the pathways available for certification and licensing, and institutional reluctance to consider non-US-trained candidates. International medical graduates applying to postgraduate training programs compare favorably with US-trained candidates in terms of clinical experience, prior formal postgraduate training, and research, but have higher application withdrawal rates and significantly lower residency and fellowship match rates, a disparity that may be exacerbated by the recent elimination of objective performance metrics, such as the US Medical Licensing Examination Step 1 score. Once legally in the US, IMGs encounter additional obstacles to board eligibility, research funding, and career progression. International medical graduates offer a viable and available solution to bridge the domestic physician supply gap, while improving workforce diversity and meaningfully addressing the public health implications of geographic maldistribution of general and specialist physicians, without disrupting existing physician stature and salaries. The US remains unable to integrate IMGs until systematic policy changes at the national level are implemented.

Alcohol control policy and alcohol-attributable disease burden in Finland and the Baltic countries: A longitudinal study 1995-2019.

Alcohol remains a significant contributor to mortality and morbidity in Finland and the Baltic countries, particularly among men. This study aimed to assess alcohol policy restrictiveness in this region from 1995 to 2019 using a modified version of the Bridging the Gap (BtG-M) policy scale and examine its association with alcohol-related disease burden. The study utilised national laws to score policy restrictiveness (higher BtG-M scores mean stricter policies) and age-standardised rates of disability-adjusted life years (DALY), years of life lost, years lived with disability and deaths per 100,000 from the 2019 Global Burden of Disease Study (GBD). Spearman correlation tests and panel data regression models were applied to assess the association between policy score and burden of disease. Finland maintained a high BtG-M score, while the Baltic countries experienced recent increases from initially lower scores. Alcohol-related disease burden showed an inverse association with policy changes in these countries. Strongest association was seen between the BtG-M score and DALY rates attributed to injuries. Premature mortality among men constituted the largest proportion of disease burden. Despite challenges in accessing and comparing policy data over time, we showed a strong association between alcohol policy and alcohol-related harm in Finland and the Baltic countries. This study is one of the first to use the BtG-M scale to monitor changes in alcohol policies over time and their relationship to alcohol-related harm using GBD methodology. The study highlights the effects of national alcohol policies on levels of alcohol-related harm.

TAX BUOYANCY IN MAJOR STATES IN INDIA

In the world of fiscal policy, tax elasticity and buoyancy are crucial factors shaping a country's financial health. Tax elasticity measures how much tax revenue changes when national income shifts, showing how flexible the tax system is naturally, without deliberate policy changes. This flexibility helps stabilize revenue, reducing the need for constant tweaking of tax policies. On the other hand, tax buoyancy reflects how tax revenue responds to economic shifts and intentional changes in tax policies. It acts like a gauge, indicating how effectively taxes adjust to economic ups and downs and how well policy decisions influence revenue. Low buoyancy suggests that there might be flaws in the tax system, prompting policymakers to rethink and improve tax strategies to better fit economic realities. For a country like India, where tax revenues are essential for financing public spending, understanding these metrics is critical. The buoyancy coefficient compares the growth of actual tax revenue to national income growth, providing insights into how successful fiscal policies are in boosting tax revenues. Meanwhile, the elasticity coefficient shows how responsive the tax system is to changes in national income, revealing its potential to generate more revenue as the economy grows. Analyzing these metrics gives policymakers a detailed view of fiscal sustainability and economic stability. It helps them make informed decisions when designing tax policies, ensuring that the government can maximize revenue while allowing the tax system to adapt smoothly to economic changes. A balanced approach that considers both elasticity and buoyancy is key for India's fiscal strategy, ensuring a well-coordinated financial performance that aligns with national economic goals. KEYWORDS :- Tax Buoyancy, Tax Elasticity, Fiscal Policy, Tax Revenue, NITI Aayog, RBI (Reserve Bank of India), VAT (Value Added Tax), GST (Goods and Services Tax).

Accessing supports due to others' harmful drinking.

Alcohol's harm to others (AHTO) refers to harms caused to those other than the drinker. The current paper estimates the prevalence of formal and informal supports sought due to AHTO and examines whether the type of support accessed varies by sociodemographic, economic and harm-related characteristics. An Australian sample of 2574 people completed the 2021 AHTO survey, out of which 888 perceived they experienced harm from another's drinking. Prevalence of accessing services and supports was measured. Additionally, several sociodemographic factors, economic factors and harm-related factors were included in multivariable logistic regression models predicting service/support use. Specifically, four models were constructed probing use of any service/support, use of police, use of counselling services and use of family/friend support. Of the survey sample, 12.4% accessed any support/service. Seeking support from family and/or friends was most common, followed by police, counselling, healthcare services and being admitted to hospital. Women had higher odds of accessing counselling and family/friend support. Respondents with a higher education level and two or more financial stressors had higher odds of accessing police and counselling. Respondents harmed by a stranger had higher odds of accessing police, whereas respondents harmed by someone they know had higher odds of seeking support from family/friends. Experiencing more severe harm was associated with greater odds of accessing any support. Several sociodemographic and economic factors were associated with accessing different supports. These findings may inform service development, interventions and policy changes for people affected by others' drinking.

No improvement in AUDIT-C screening and brief intervention rates among wait-list controls following support of Aboriginal Community Controlled Health Services: evidence from a cluster randomised trial

BackgroundWhile Aboriginal and Torres Strait Islander Australians are less likely to drink any alcohol than other Australians, those who drink are more likely to experience adverse alcohol-related health consequences. In a previous study, providing Aboriginal Community Controlled Health Services (ACCHSs) with training and support increased the odds of clients receiving AUDIT-C alcohol screening. A follow-up study found that these results were maintained for at least two years, but there was large variability in the effectiveness of the intervention between services. In this study, we use services that previously received support as a comparison group to test whether training and support can improve alcohol screening and brief intervention rates among wait-list control ACCHSs.MethodsDesign: Cluster randomised trial using routinely collected health data. Setting: Australia. Cases: Twenty-two ACCHSs that see at least 1000 clients a year and use Communicare as their practice management software. Intervention and comparator: After initiating support, we compare changes in screening and brief intervention between wait-list control services and services that had previously received support. Measurement: Records of AUDIT-C screening and brief intervention activity in routinely collected data.ResultsDuring the reference period we observed 357,257 instances where one of 74,568 clients attended services at least once during a two-monthly data extraction period. Following the start of support, the odds of screening (OR = 0.94 [95% CI 0.67, 1.32], p = 0.74, \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$B{F}_{10}$$\\end{document}\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\approx$$\\end{document} 0.002) and brief intervention (OR = 1.43 [95% CI 0.69, 2.95], p = 0.34, \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$B{F}_{10}$$\\end{document}\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\approx$$\\end{document} 0.002) did not improve for the wait-list control group, relative to comparison services.ConclusionsWe did not replicate the finding that support and training improves AUDIT-C screening rates with wait-list control data. The benefits of support are likely context dependent. Coincidental policy changes may have sensitised services to the effects of support in the earlier phase of the study. Then the COVID-19 pandemic may have made services less open to change in this latest phase. Future efforts could include practice software prompts to alcohol screening and brief intervention, which are less reliant on individual staff time or resources.Trial registrationRetrospectively registered on 2018-11-21: ACTRN12618001892202.

Immersive learning in a block teaching model: A case study of academic reform through principles, policies and practice

Universities across the globe are considering how to effect meaningful change in their higher education (HE) delivery in the face of the COVID-19 pandemic and shifting student learning preferences. This paper reports on a descriptive case- study of whole-of-institution curriculum reform at one regional Australian university, where more traditional 13-week semesters have been replaced with a 6-week immersive block model known as the Southern Cross Model. Based on a synthesis of literature in best practice HE pedagogy and principles, the case study draws on both a review of policy and staff interviews (N = 5) to outline the key changes necessary for successful HE transformation. Analysis revealed themes related to the vital roles of leadership, capacity building, monitoring the transition, staff adoption, and adequate technical systems in implementing a radical, multifaceted institutional transformation. Implications for practice at institutions considering reforming their curriculum model are also discussed. The findings from this case study indicate that an institutional transformation to an immersive block model requires both a considered change in institutional policy and process, as well as the appropriate resourcing of roles, governance committees, technical solutions, and, importantly, communities of practice.

Black swans swimming in product streams: method for including unplanned events in life cycle assessment

Abstract Introduction Unplanned events such as accidents and more massive black-swan events are contingent to modern technology. However, varying approaches and inconsistent guidelines make the inclusion of unplanned events in life cycle assessment (LCA) uncommon and challenging. This paper discusses the relevance of considering unplanned events in LCA and shows how they can be included in LCA practice. Method A theoretical background to the concepts of black swans, accidents, and unplanned events is first provided. We then propose a method for how unplanned events can be included in LCA practice, illustrated through three cases: (i) a sabotage in the energy system, (ii) an accident in the use phase, and (iii) a sudden policy change. Results The results show that unplanned events can be included and may significantly affect LCA results, sometimes even fulfilling criteria for black-swan events. Conclusions We suggest that unplanned events should be included in LCA when relevant, e.g. as one scenario in LCAs of product systems sensitive to accidents. We also suggest that changes in flows due to unplanned events should be considered in unit processes, so that their impacts become distributed across downstream product systems depending on demand for the unit-process output.

Knowledge, attitudes, and practices of Japanese physicians relating to climate change impacts on health, delivery of climate-specific advice, and advocacy for climate change policies

Abstract Aim This study aimed to assess the knowledge, attitudes, and practices (KAP) of physicians in Japan toward climate change and health, their delivery of climate-specific advice to patients, and their advocacy for climate change policy. Subject and methods This cross-sectional study included licensed physicians active in clinical practice in Japan. Data were collected through a web-based platform from November 21 through November 27, 2023, using a 32-item self-administered questionnaire. Results A total of 1100 physicians with a mean age of 51.2 years (SD11.9) were included in the analysis. More than half (56.7%) agreed that physicians should advise their patients on the links climate change has on their health; however, less than half (32.6%) of the physicians responded that they do. Among the factors that reduced their action to deliver climate-specific health advice and advocacy were a lack of information/resources and knowledge. The multivariable logistic regression model showed that having prior climate change education or training, knowledge, and awareness is associated with physicians’ delivery of climate-specific advice to patients and advocating for climate change policy. Conclusion Many physicians recognize their responsibility to educate their patients on the impact climate change has on their health. There is a significant gap between the physicians’ willingness and what happens in practice. Among the main factors that reduce their action to engage in delivering climate-specific health advice and advocacy were a lack of information/resources and a lack of knowledge. Physicians need to be better equipped with the education, resources, and support to apply their expertise and influence to combat climate change.

Knowledge in motion: temporal dynamics of wild food plant use in the Polish-Lithuanian-Belarusian border region

BackgroundUnderstanding how Local Ecological Knowledge (LEK) evolves over time is crucial for fostering social and environmental responsibility. This study aims to develop a conceptual model of plant knowledge circulation, providing insights into the temporal dynamics of LEK in the Polish-Lithuanian-Belarusian border region. It explores the key patterns and driving forces behind changes in the use of wild plants for food.MethodsField research was conducted in 60 rural settlements across Podlasie Voivodeship (Poland), Vilnius Region (Lithuania), and Hrodna Region (Belarus). This included 200 semi-structured interviews and participant observation among two local communities, Lithuanians and Poles. To assess the temporal dynamics of wild food use, we performed a cross-ethnic, cross-border analysis over time, dividing the data into three major temporal dimensions: past, continuous, and recently acquired uses.ResultsOf the 72 wild plant taxa reported by Poles or Lithuanians in the Polish-Lithuanian-Belarusian borderland, 47 were continuously used for food, 58 were utilised in the past, and 41 were recently acquired. Cross-country trends were similar, with Poland showing more past uses. Diachronic comparisons between Poles and Lithuanians in each studied country revealed no significant differences. Recently acquired taxa overlapped considerably with those used continuously and in the past. The most diversely utilised taxa showed the greatest overlaps. By observing the movement of specific plant taxa within various time dimensions, we distinguished overlapping flow variations: retention (3 taxa), decay (11), invention (8), stagnation (17), revitalisation (6), re-invention (3), and knowledge in motion (24). Shifts in the use of wild food plants were influenced by changes in environmental conditions, governmental policies, cultural practices, and economic factors.ConclusionThe findings of this study have important implications for improving methods of tracking changes in LEK and enhancing our understanding of the relationship between people and nature. Our results underscore the importance of considering knowledge circulation over time in different directions. Recognising the various stages of knowledge circulation might help in pursuing sustainable solutions that balance the needs of human communities with environmental protection.

Changes in maternity care policies and practices that support breastfeeding as measured by the Ten Steps to Successful Breastfeeding — United States, 2018–2022

BackgroundExperiences during the birth hospitalization affect a family’s ability to establish and maintain breastfeeding. The Ten Steps to Successful Breastfeeding (Ten Steps) describe evidence-based hospital policies and practices shown to improve breastfeeding outcomes. We aim to describe hospitals’ implementation of the Ten Steps, changes over time, and hospitals’ implementation of a majority (≥ 6) of the Ten Steps by hospital characteristics and state.MethodsThe biennial Maternity Practices in Infant Nutrition and Care (mPINC) survey assesses all hospitals in the United States (including the District of Columbia and territories) that routinely provide maternity care services. We analyzed data from 2018, 2020, and 2022 survey cycles to describe trends in the prevalence of hospitals implementing maternity care policies and practices that are consistent with the Ten Steps. Differences were calculated using the absolute difference in percentage-points between 2018 and 2022.ResultsBetween 2018 and 2022, the percentage of hospitals that implemented Step 2: Staff Competency and Step 5: Support Mothers with Breastfeeding increased 12 and 8 percentage points, respectively. The percentage of hospitals that implemented Step 6: Exclusive Breastfeeding Among Breastfed Infants was 7 percentage points lower in 2022 than 2018. Implementation of the remaining seven steps did not change by more than 5 percentage points in either direction between 2018 and 2022. Nationally, the percentage of hospitals that implemented ≥ 6 of the Ten Steps increased from 44.0% in 2018 to 51.1% in 2022. Differences were seen when comparing implementation of ≥ 6 of the Ten Steps by hospital characteristics including state, hospital size, and highest level of neonatal care offered.ConclusionsNationally, maternity care policies and practices supportive of breastfeeding continued to improve; however, certain practices lost progress. Differences in implementation of the Ten Steps were observed across states and by certain hospital characteristics, suggesting more work is needed to ensure all people receive optimal breastfeeding support during their delivery hospitalization.

<i>Ženski list</i>

Objective. The aim of this paper is to explore the development and changes in the publishing policy of the women's magazine Ženski list, whose chief editor was Marija Jurić Zagorka. The magazine was published during the interwar period and significantly influenced the residents of the Kingdom of Yugoslavia and emigrants abroad with its content. Approach/Methodology. The analysis of the magazine was conducted based on the most visually striking and/or important issues from each year of publication, totaling 14 issues. The analysis included the number of pages, quantity of illustrations and advertisements, citation of responsibility data, and graphic and thematic changes in the magazine design. Sources from the Stare novine portal and the Center for Women's Studies were used. Results. The paper provides a brief historical overview of women's magazines worldwide, in Europe, and in the Kingdom of SHS/Yugoslavia. Furthermore, Marija Jurić Zagorka is highlighted as the journalist, and editor, followed by an analysis of the magazine issues. The uniqueness of this magazine lies in achieving high circulation and reaching readers from all social circles. Despite financial difficulties due to the non-receipt of subscriptions and economic crises, the magazine, in its 14 years of publication, kept up with innovations in the layout of visual and textual contributions. A significant increase in illustrations and advertisements is noted, indicating the magazine's close connection to its social environment, especially businesses and shops in Zagreb. There is also an observed increase in attributing authors to texts and photos or indicating the source from which the content was taken, demonstrating the editorial understanding of the concept of intelectual property. Originality/Value. This paper provides an overview of publishing and editorial practices. In addition to technical characteristics, the paper offers a partial insight into the magazine's content, placing it in the context of publishing for women, by women, in the 1920s and 1930s.

Retrospective Outcomes Comparison by Treatment Location for Pediatric Mild and Moderate Diabetic Ketoacidosis.

Pediatric diabetic ketoacidosis (DKA) is often treated in a PICU, but nonsevere DKA may not necessitate PICU admission. At our institution, nonsevere DKA was treated on the floor until policy change shifted care to the PICU. We describe outcomes in pediatric mild to moderate DKA by treatment location. Patients aged 2 to 21 with mild to moderate DKA (pH <7.3 but >7.1), treated on the floor from January 1, 2018 to July 31, 2020 and PICU from August 1, 2020 to October 1, 2022 were included. We performed a single-center, retrospective cohort study; primary outcome was DKA duration (from emergency department diagnosis to resolution), secondary outcomes included hospital length of stay, and complication rates, based on treatment location. Seventy nine floor and 65 PICU encounters for mild to moderate pediatric DKA were analyzed. There were no differences in demographics, initial pH, or bicarbonate; PICU patients had more acute kidney injury on admission. Floor patients had a shorter DKA duration (10 hours [interquartile range 7-13] vs 11 hours [9-15]; P = .04), and a shorter median length of stay (median 43.5 hours [interquartile range 31-62] vs 49 hours [32-100]; P < .01). No patients had clinical signs of cerebral edema; other complications occurred at similar rates. PICU patients received significantly more intravenous electrolyte boluses, but there were no differences in dysrhythmia or electrolyte abnormalities on final serum chemistry. Our study did not find a clear benefit to admitting patients with mild to moderate DKA to the PICU instead of the hospital floor. Our findings suggest that some children with nonsevere DKA may be treated safely in a non-PICU setting.

Implementing Policy and Practice Changes to Support Breastfeeding Duration in New York State Communities.

The health benefits of breastfeeding are well-documented, but rates of breastfeeding duration in the US fall below national targets - especially when mothers have less education, have lower incomes, are non-Hispanic Black, or live in nonmetropolitan areas. The Creating Breastfeeding Friendly Communities program was designed to promote breastfeeding and reduce disparities by implementing policy and practice changes in worksites from 2017 through 2023. The purpose of this evaluation was to determine whether the program was effective in increasing breastfeeding supports and addressing disparities. We used a 14-item tool to assess breastfeeding policies and practices at baseline and follow-up at each worksite. We used number of employees to determine worksite size, and we used worksite address to calculate social vulnerability of the community where each site was located and to classify rurality of the county where sites were located. We found significant improvements in the number and quality of breastfeeding supports available at participating worksites (N = 292 at baseline and follow-up). The program successfully reached worksites in socially vulnerable communities. Supports for breastfeeding increased in all worksite subgroups, but they increased less at worksites that were small or rural. The evaluation supports the effectiveness of worksite lactation programs and protective labor laws. Findings suggest that special attention must be given to worksites that are small, located in socially vulnerable communities, or rural counties, to support implementation and reduce disparities.

How do stock markets react to dividend announcements during the COVID-19 pandemic? Evidence from the GCC markets

Purpose This study aims to investigate how stock markets responded to corporate dividend policy changes during the COVID-19 pandemic in the Gulf Cooperation Council (GCC) countries. Likewise, it explores how efficiently market prices incorporate the news by examining the speed of stock price adjustment to various dividend announcements. Design/methodology/approach The sample includes 741 dividend announcements from 2017 to 2021 made by 326 firms listed in the stock markets of the GCC countries. A series of regression analyses examine how dividend announcements influence the market reaction during the COVID-19 pandemic, controlling for other well-documented firm characteristics. Findings This study reveals an adverse stock price reaction to all the dividend announcements in most GCC markets. The findings also show strong asymmetric effects of COVID-19 on how the markets react to different dividend changes. Likewise, the authors show that investors tend to underreact to the good news of dividend increases amid hard times of crises due to prevailing uncertainty and bearish sentiment. Besides, regression results reveal that firms with dividend reductions during the pandemic experience less adverse market reactions than dividend-decreasing firms prepandemic. Practical implications For firms, the findings confirm the role that corporate dividend policy can play in conveying signals to investors, especially during hard times of crises and turbulences, thereby affecting their share price. For policymakers, the results substantially affect market efficiency and firm valuation in the GCC markets. Originality/value This study is not only one of the first few attempts to scrutinize how the pandemic has affected the market reaction to changes in corporate dividend policies but also, to the best of the authors’ knowledge, it is the first to examine how corporate dividend policy could affect stock markets during COVID-19 in the context of GCC markets.

Estimating vaccine effectiveness against COVID-19 using cause-specific sick leave as an indicator: a nationwide population-based cohort study, Norway, July 2021 – December 2022

BackgroundDue to changes in testing policy and increased use of rapid tests, other indicators for SARS-CoV-2 infections are needed to monitor vaccine effectiveness (VE). We aimed to estimate VE against COVID-19 sick leave (> 3 days, certified by a medical professional) among employed individuals (25–64-years-old) in Norway.MethodsWe performed a nationwide cohort study by collating data from the Emergency preparedness register for COVID-19. We used adjusted Cox proportional hazard models with vaccine status as a time-varying covariate and presented results as adjusted hazard ratios (aHRs) with corresponding 95% confidence intervals. Separate models were run against sick leave and against SARS-CoV-2 infections during the Delta period (June-December 2021), and against sick leave during the Omicron period (January-December 2022) when SARS-CoV-2 PCR-testing was replaced by rapid self-tests and infections were underreported.ResultsWe included 2,236,419 individuals during the Delta period, of whom 73,776 (3.3%) had a reported infection and 54,334 (2.4%) were registered with sick leave. Of the 2,206,952 included individuals in the Omicron period, 300,140 (13.6%) were registered with sick leave. During the Delta period, 55% (26,611) of individuals who had registered sick leave also had a positive test, compared to 32% (96,445) during the Omicron period. The VE against sick leave during the Delta period followed a similar waning pattern to that against SARS-CoV-2 infections. After the second and third dose, the lowest aHRs were estimated for 2–7 days after vaccination for both sick leave (0.25; 95%CI 0.24–0.26 and 0.26; 95% CI 0.24–0.29) and infection ( 0.16; 95% CI 0.15–0.17 and 0.18; 95% CI 0.16–0.19) respectively. During the Omicron period, aHRs for sick leave were higher than during the Delta period, but the lowest aHRs were still found in 2–7 weeks after receiving the second (0.61; 95% CI 0.59–0.64) or third dose (0.63; 95% CI 0.62–0.64).ConclusionOur results showed that sick leave could be a relevant indicator for VE in the surveillance of COVID-19 and a finding that may be important in the surveillance of other respiratory infection.

Geographical targeting of active case finding for tuberculosis in Pakistan using hotspots identified by artificial intelligence software (SPOT-TB): study protocol for a pragmatic stepped wedge cluster randomised control trial

IntroductionPakistan has significantly strengthened its capacity for active case finding (ACF) for tuberculosis (TB) that is being implemented at scale in the country. However, yields of ACF have been lower...

Rethinking climate change vulnerabilities after COVID‐19: Recommendations for social science‐based interventions drawn from research on Conspiracy Theories and Diversity Science

AbstractScholars have noted several connections between the COVID‐19 pandemic and the climate crisis, ranging from the material influence of the pandemic on climate change processes (e.g., how lockdowns temporarily lowered climate emissions) to the similar ways the crises have been managed. Both crises are also global in scope, have exerted a significant toll on human lives and require major changes in our lifestyles. However, while collective responses to COVID‐19 were rapid and concerted, efforts to address climate change continue to be met with resistance. In this article, we investigate the social vulnerabilities common to both crises and the lessons that policymakers in the climate field can take away from the pandemic. After outlining the theoretical and empirical similarities between the two crises, we present a general framework and recommendations for the use of social science‐based interventions. We focus on two broad topics of contemporary interest that lay bare social vulnerabilities of the coronavirus pandemic—conspiracy theories and racial and ethnic inequities—to highlight the ways that understanding social and psychological processes associated with the pandemic can help inform more efficient climate policies.Public Significance StatementThis paper shows how the COVID‐19 pandemic's social and psychological lessons can guide climate change policies. By leveraging social science insights, we propose strategies and illustrations to combat misinformation and address social inequities, ultimately fostering more effective and inclusive climate actions and benefiting policymakers and society at large.

Language Ideologies and Identity Construction in Immigrant Communities

Purpose: This study sought to explore language ideologies and identity construction in immigrant communities. Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library. Findings: The findings reveal that there exists a contextual and methodological gap relating to language ideologies and identity construction in immigrant communities. Preliminary empirical review revealed that dominant language beliefs significantly impacted how immigrants navigated their identities, often pressuring them to assimilate linguistically at the expense of their native languages and cultures. Immigrants employed various strategies, such as forming ethnic enclaves and participating in cultural events, to maintain their linguistic heritage. The study highlighted the crucial role of educational institutions and inclusive policies in supporting bilingualism and multiculturalism, which were essential for the social integration and identity preservation of immigrants. Ultimately, it emphasized the need for concerted efforts from policymakers, educators, and community organizations to promote linguistic diversity and cultural heritage to enhance the well-being and cohesion of immigrant communities. Unique Contribution to Theory, Practice and Policy: The Social Identity Theory, Bourdieu's Theory of Habitus and Cultural Capital and Critical Race Theory may be used to anchor future studies on language ideologies and identity construction in immigrant communities. The study recommended incorporating intersectional approaches into theoretical frameworks to better capture the dynamic nature of identity formation. It advised educators to adopt inclusive pedagogical strategies that value linguistic diversity and suggested training programs to enhance cultural competence. Policy recommendations included implementing bilingual and multilingual education programs, combating linguistic discrimination, and promoting linguistic diversity in public spaces. The study contributed to theory by integrating concepts of linguistic capital into social identity theories, offered practical guidance for supporting immigrant populations, and advocated for systemic policy changes to create a more equitable and inclusive society.