Development Of Effective Public Policies Research Articles

Prevalence of Gender Dysphoria in Southern Brazil: A Retrospective Study.

To ensure that public health services provide comprehensive and inclusive health care to the general population, it is important for countries to estimate how many of their citizens experience gender dysphoria and wish to receive specialized hormone treatment or gender-affirming surgery. The aim of this study was to estimate the prevalence of individuals with gender dysphoria seeking transgender health care in a public teaching hospital in southern Brazil. In this retrospective follow-up study, we analyzed the medical records and sociodemographic data of individuals aged > 15years living in Rio Grande do Sul, Brazil, that enrolled in a specialized program to receive hormone therapy and gender-affirming surgery between 2000 and 2018. This study is the first to attempt estimating the prevalence of gender dysphoria in Rio Grande do Sul; it describes novel data on the clinical profile of individuals with gender dysphoria treated in a public hospital specialized in providing transgender health care. Prevalence estimates were calculated based on statewide annual population data in the study period. Of 934 identified individuals, 776 (601 trans women and 175 trans men) were included in this study. The overall prevalence of individuals with gender dysphoria was 9.3 per 100,000 individuals (95% CI: 8.6 to 9.8). Meanwhile, there were 15 trans women per 100,000 people (95% CI: 14 to 16) and 4.1 trans men per 100,000 people (95% CI: 3.5 to 4.8). There was a progressive increase in the number of people seeking hormone therapy and gender-affirming surgery during the study period. Future research is needed to determine the size of the trans population in other regions of Brazil and to expand the knowledge regarding gender dysphoria to allow for the development of effective public policies for people with gender dysphoria.

Оценка уровня бедности в России: зависимость от методологии измерения

Poverty reduction is one of the main objectives of the state policy in the Russian Federation. In the decree of the President of the Russian Federation No. 474 of 21.07.2020 «On the national goals of the Russian Federation for the period up to 2030,» a target is determined - reducing the poverty level by half by 2030. To measure poverty in the Russian Federation until 2021, the absolute concept was used. Within the framework of this concept, it is planned to create a minimum standard on the basis of which the level of poverty was determined. In the Russian Federation, a consumer basket is adopted as a standard, on the basis of which the cost of living is calculated. The cost of living is the threshold for poverty. Since 2021, the methodology for measuring poverty has changed, the calculation is based on the relative concept, the median method is used to measure poverty. A number of countries also use the multidimensional poverty concept with a set of indicators to measure poverty. The article provides a comparative analysis of methodological approaches for poverty assessment. The article proves that the level of poverty depends on the methodological approach underlying its measurement. The author believes that only a multidimensional approach to measuring poverty will contribute to the development of effective public policies to overcome poverty.

Analysis of the attributes to decision-making process of the urban freight vehicle choice for Brazilian scenario

The largest cities in Brazil are experiencing a crisis in their urban mobility model. It increases the complexity of the urban distribution process, which requires a considerable effort in decisions such as vehicular choice for urban freight transport. Some attributes might influence the commercial vehicle choice by the decision makers, and they may be related to aspects of the vehicle, the cargo, the delivery area, the freight vehicle restrictions and the requirements from the operation. Recognising this challenge, the key attributes that influence the urban freight vehicle choice were identified through a systematic literature review and their adherence to the Brazilian reality was evaluated through a survey. Also, a stated preference survey was carried out to measure the relationship between decisions on the choice of commercial vehicular mode and the main attributes in this process. The results could support urban transport planners in the development of effective public policies.

SPATIOTEMPORAL VARIATION IN THE PRECIPITATION OF THE AMAZON COASTAL ZONE: USE OF REMOTE SENSING AND MULTIVARIATE ANALYSIS

Reliable data on the spatiotemporal variability in precipitation patterns are vital to the development of effective public policies for environmental management. The analysis of the variation in rainfall rates is currently limited severely by the dependence on data from rain gauges, in particular in regions with a relatively sparsely-distributed network of meteorological stations, as in the Amazon region. The present study investigated the variability in the precipitation and the principal rainfall patterns at different time scales in the coastal zone of the Amazon region, and associated these patterns with the precipitant meteorological systems present in the region. The study was based on the application of remote sensing (CMORPH) data taken at half-hourly intervals on a 0.088 latitude/longitude scale. The spatiotemporal variability in the region’s precipitation was analyzed at different time scales (monthly, seasonal, and annual), with distribution patterns being assessed using a Principal Components Analysis (PCA). The estimates obtained from the CMORPH data provided a satisfactory overview of the precipitation climatology of the study region at the distinct time scales. The PCA identified a precipitation gradient in the two principal pluviometric modes, which together explained 88% of the total variance in the data. The first mode explained 83% of the variance, with two distinct periods, a rainy season and a dry (or less rainy) period, which are influenced by large-scale precipitant systems, the Intertropical Convergence Zone (ITCZ) and High Level Cyclonic Vortices (HLCVs). The second mode, which explains 5% of the variance in the rainfall data, is associated with mesoscale systems that affect primarily the transition periods between the seasons, and depend on the southern extreme of the annual shift in the ITCZ. The understanding of the variation of precipitation patterns using high-resolution CMORPH data, with a comprehensive coverage in both time and space, provides an effective tool for the establishment of public policies at a municipal level, in particular the development of models, and the mediation of the vulnerability of local populations to climatic extremes.

The health policy implications of individual adaptive behavior responses to smog pollution in urban China

Smog pollution is a serious public health issue in urban China, where it is associated with public health through a range of respiratory and cardiovascular illnesses. Despite the negative health impacts of smog pollution, individual adaptive behaviors are poorly understood. This knowledge gap hinders the development of effective public policy to support and encourage the adoption of individual adaptive and mitigating behaviors to smog pollution. A questionnaire survey of 1141 randomly sampled individuals in a typical PM2.5-polluted Chinese city was designed to establish smog concerns and behavior changes during smog events. The results demonstrate a variety of behavior responses associated with risk perception, experience of smog, age, and gender of respondents. An understanding of these variations is critical to the development of effective public policy and ultimately to the improvement of public health in cities affected by smog.

Invisibilidade e (des)tratos nos atendimentos dos maus tratos na Proteção Integral: a necessidade de uma governança de dados e reorientação de fluxos

A partir dos postulados da doutrina da proteção integral estabelecida pela Constituição da República de 1988 e pelo Estatuto da Criança e Adolescente (Lei 8.069/90), pretende-se refletir sobre o conceito e a problemática dos reflexos cíveis e criminais dos maus tratos como espécie comum de violência intrafamiliar praticada contra crianças e adolescentes. Para além da análise do tema sob perspectiva crítica, objetiva-se analisar deficiências de fluxo na dinâmica de funcionamento das instituições responsáveis (Conselho Tutelar, órgãos de Segurança Pública, Defensoria Pública, Ministério Público e Poder Judiciário), bem como sugere-se melhor gestão e tecnologia da informação para prevenção e elaboração de políticas públicas efetivas e necessárias para o trato da questão em harmonia com o ordenamento jurídico atual.

EPIDEMIOLOGIA E DISTRIBUIÇÃO ESPACIAL DA TUBERCULOSE MULTIRRESISTENTE (TBMR) NO BRASIL NOTIFICADA ATRAVÉS DO SINAN, 2008-2012.

Backgound and Objectives: Multidrug-resistant tuberculosis (MDR-TB) is defined as resistance to at least rifampicin and isoniazid, important drugs in TB treatment. It represents an important public health problem in Brazil and worldwide, considering its implications on the morbimortality of affected patients. Given this context, this study aims to describe the epidemiological and spatial characteristics of MDR-TB in Brazil. Methods: This is a retrospective study of MDR-TB cases diagnosed in Brazil between 2008 and 2012. The sample consisted of cases reported to SINAN, totaling 645 cases according to variables related to time (year), space (place of occurrence) and the individual (characteristics of the disease in the studied populations). Descriptive analyses were performed using the software Microsoft Excel 2010® and TabWin 3.2®. Results: Of the 645 cases analyzed, 65.74% patients were male, with a wide age range and a higher prevalence between 20 and 60 years (81.24%) in mixed ethnicity (45.27%) and individuals with low educational level. There was little association between MDR-TB and HIV (8.68%). Pulmonary disease was frequent (92.4%). Rio de Janeiro (25.74%), Rio Grande do Sul (12.84%) and Pará (8.99%) have most of the cases. The percentage of patients who developed MDR-TB from TB was higher in Roraima (0.68%). Conclusion: This study allowed us to understand the general characteristics of MDR-TB in Brazil and its spatial distribution in the states. The development of effective public policies for TB control starts with the knowledge of its characteristics in the affected populations, as well as the identification and adequate treatment of cases aiming to reduce multidrug resistance cases

Assessment of the Average Price and Ethanol Content of Alcoholic Beverages by Brand—United States, 2011

There are no existing data on alcoholic beverage prices and ethanol (EtOH) content at the level of alcohol brand. A comprehensive understanding of alcohol prices and EtOH content at the brand level is essential for the development of effective public policy to reduce alcohol use among underage youth. The purpose of this study was to comprehensively assess alcoholic beverage prices and EtOH content at the brand level. Using online alcohol price data from 15 control states and 164 online alcohol stores, we estimated the average alcohol price and percent alcohol by volume for 900 brands of alcohol, across 17 different alcoholic beverage types, in the United States in 2011. There is considerable variation in both brand-specific alcohol prices and EtOH content within most alcoholic beverage types. For many types of alcohol, the within-category variation between brands exceeds the variation in average price and EtOH content among the several alcoholic beverage types. Despite differences in average prices between alcoholic beverage types, in 12 of the 16 alcoholic beverage types, customers can purchase at least 1 brand of alcohol that is under $1 per ounce of EtOH. Relying on data or assumptions about alcohol prices and EtOH content at the level of alcoholic beverage type is insufficient for understanding and influencing youth drinking behavior. Surveillance of alcohol prices and EtOH content at the brand level should become a standard part of alcohol research.

BIOETHICS AND DEMOCRACY: COMPETING ROLES OF NATIONAL BIOETHICS ORGANISATIONS

ABSTRACTIn establishing National Bioethics Organisations (NBOs), liberal democracies seek to acknowledge the diversity of strongly held ethical positions and the imperative to engage in public debate about important bioethical decisions. NBOs are typically given a range of responsibilities, including contributing to and stimulating public debate; providing expert opinion on relevant issues for policy deliberations; and developing public policy. The state is now found to have an interest in areas previously thought to be a matter of individual choice. NBOs can provide one way of opening up public debate to allow the diversity of views to be heard in a manner that is well‐informed, articulate and responsive to both expert and ‘lay’ public views. We draw on debates in political theory about democratic decision‐making and on the policy making roles of some key NBOs. We are particularly interested in examining the capacity of NBOs to meet the democratic ideal of effective participation by the public, or citizenry, especially by those who are directly affected by the policies, in the development of effective public policy. We provide a basic framework for policy development involving NBOs that can begin to meet this ideal, a process of ‘contested deliberation’.