Direct cash transfers are an increasingly common tool to alleviate poverty, but critics argue that recipients will use this cash in irresponsible and potentially dangerous ways. To investigate the impact of cash payments on traumatic injury and death, we turn to Alaska's long-standing statewide cash transfer, the Permanent Fund Dividend. Nearly every Alaskan receives a substantial amount of money (average $1,500 per person) on a single day in the fall of each year. Using interrupted time series analyses paired with 2009-2019 data on all traumatic injuries (N = 36,556) seen at Alaska hospitals from the state's trauma registry and all deaths (N = 43,170) from vital records, we examine whether the payment causes an increase in traumatic injury and mortality in the days following disbursement. Despite commonly held fears, we find no such increases in our data across multiple specifications. These results provide no evidence to suggest that direct cash payments increase the risk of injury or death.

For many large carnivores, minimizing the financial burden they impose on local people is critical to their conservation. Incentive-based programs that provide people with financial benefits for taking pro-conservation actions or achieving conservation goals are a promising tool for promoting human-carnivore coexistence. Although the number of incentive-based programs aimed at conserving large carnivores is growing, there has been little published research on the use of this approach. We reviewed the design, implementation, and results of a novel lion conservation incentive payment (CIP) program piloted in Tanzania's Ngorongoro Conservation Area. Under the program, developed in collaboration with local stakeholders, villages earned direct payments based on the number of lions observed on their land each month. During the program's 3-year pilot period, villages earned more than double the value of livestock injured or killed by lions and used their earnings primarily to support education-related projects. A household survey conducted at the conclusion of the pilot indicated widespread awareness of and support for the CIP program. Lessons from this experience that may be valuable for the development of similar incentive-based conservation schemes in Tanzania and beyond include the importance of developing a practical and dynamic earnings framework, evaluating and adaptively managing program communications, supporting participating stakeholders to effectively deploy their CIP earnings, and identifying potential sources of sustainable funding.

Abstract Mountain regions are highly vulnerable to climate change, yet governance of climate change mitigation (CCM) in agriculture remains dominated by top-down and sectoral approaches. This article examines how policy instruments shape the implementation of CCM in mountain livestock farming, focusing on Haute-Savoie (France) and the Canton of Valais (Switzerland). Combining policy instrument analysis with 31 semi-structured interviews with key state and local policy stakeholders, eleven farm visits, and document review, we assess how different institutional contexts structure farmer participation. Our findings challenge the assumption that decentralization automatically facilitates local climate action. In Switzerland, federal direct payments and project-based initiatives sustain strong farmer dependence on state support but generate only weak and fragmented territorial coalitions. In France, by contrast, the common agricultural policy (PAC) has paradoxically stimulated territorial governance through agro-environmental and climate projects (PAEC), even within a centralized system. However, farmer participation remains uneven and dominated by technical experts, while national farm unions often resist climate greening. The article contributes to the literature on policy implementation by showing how instrument design and territorial support structures condition the emergence of local coalitions for climate action. It highlights the need for long-term participatory mechanisms to strengthen the role of mountain farmers in climate mitigation strategies.

ABSTRACT Real estate developers' decision processes are intricate, involving many diverse variables. Understanding developers' decisions is crucial in Latin America, where a growing demand for social housing on better-located land exists. We test the effectiveness of different incentives to encourage developers to build highdensity and socially integrated projects near transport stations using a sophisticated stated choice survey designed to elicit developers' preferences. As the survey flow depended on the developers' answers, we formulated and estimated a discrete choice model to address inherent endogeneity issues. Our results reveal developers' preference for direct payment incentives and incentives that grant them more freedom to design projects. Further, we sadly confirm that social inclusion is a disincentive, reflecting a traditional Latin American aversion to mixed-income dwelling projects, suggesting a preference for segregated housing markets. Public policies planning to employ incentives must evaluate the monetary cost of such schemes and their consequences on local neighbourhoods.

Direct Cost and Incidence of Surgically Treated Upper-Extremity Peripheral Nerve Injuries in the United States.

Reforming nursing reimbursement: direct payment models under Iran’s Nursing Service Act in a global context

The legal framework for social conditionality within the European Union entered into force on 1 January 2025. Under these provisions, the Common Agricultural Policy (CAP) will undergo significant changes and could have important consequences if farmers and other beneficiaries are to receive direct payments or annual payments if certain standards are breached. In light of this, we have undertaken an analysis of the current state of employment practices within the agricultural sector, with the aim of providing a snapshot of the extent to which employers may need to adapt their workplace practices in the near future in order to avoid jeopardizing their eligibility for financial support.

The article explores the relevance and key aspects of managing imagemaking technologies to create a strong personal brand in the digital environment. In conditions where human capital becomes a unique competitive resource, the purposeful formation of an image and the creation of a “human brand” are of paramount importance. The essence of the “personal brand” concept is revealed as an intangible asset based on unique qualities, professionalism, and their public demonstration, in contrast to an image, which is a purposefully formed representation. The purpose of the research is to theoretically substantiate and systematize imagemaking technologies for personal brand building on social media, as well as to identify effective tools for their management and monetization. The multi-component structure of an individual's image is systematized, including the habitus (visual), kinetic, verbal, environmental, mental, and objectified elements. A universal four-stage algorithm for building a personal brand is analyzed in detail: 1) diagnostics and goal setting; 2) strategy development and selection of communication channels; 3) content creation and distribution; 4) audience interaction and analytics. The role of digital technologies, such as Big Data analysis and artificial intelligence-based tools, in modern imagemaking is highlighted. The application of imagemaking technologies in various fields is considered: in HR management for shaping the employer brand, in marketing for building brand trust through social media, and in political communications for creating a leader's image. Special attention is paid to practical tools for monetizing a personal brand on social media, which are grouped into four areas: direct payments from platforms, selling one's own products and services, collaboration with other brands, and direct financial support from the audience. Case studies are provided to illustrate the conversion of media capital into financial, political, and social influence. The importance of authenticity and ethical standards for building long-term trusting relationships with the audience as the foundation of a successful brand is substantiated.

Online health-related philanthrotainment consists of videos displaying generosity to others and presented in an entertaining way. This practice includes stunt philanthropy where recipients are surprised with a gift and their shock and gratitude are captured for viewers. It can also entail more traditional health-related philanthropic activities including direct payments for medical services like cataract surgeries and public health-related activities such as developing access to clean drinking water. These videos use advertising revenue, product placement and viewer donations to fund the production of the video and support for recipients. While health-related philanthrotainment can confer substantial benefits on the people they feature, it also raises serious ethical concerns. These concerns include the inefficient use of donations and other funding; undermining democratic priority setting in giving; failing to identify and address the root causes of need; encouraging moral licensing behaviour; and degrading and exploiting recipients. In principle, these ethical concerns can be addressed by prioritising the aim of philanthropy over entertainment, including the voices and priorities of viewers and recipients in the production of these videos, and taking lessons from successful education-oriented online communicators. In practice, the twin incentives of attracting viewers and advertisers make these changes at best difficult to implement.

Abstract The article explores the interconnection between the reformed Common Agricultural Policy (CAP) for 2023–2027 and the fundamental legislative changes in spatial planning and construction in the Slovak Republic since 2022. The CAP reform introduced an integrated strategic framework that merges direct payments and rural development, requiring alignment of national strategies with the European Union’s environmental and climate objectives. In Slovakia, a parallel reform of spatial planning and construction legislation has taken place, culminating in the adoption of Act No. 200/2022 Coll. on Spatial Planning and the new Construction Act No. 25/2025 Coll. The new legal provisions introduce an integrated procedure for construction intentions, digitalisation of administrative processes, and decentralisation of executive powers through the establishment of new regional offices with extended competences. The authors highlight the benefits of the new system (faster permitting processes, simplified administration) as well as potential risks (tight deadlines for municipalities, legal uncertainty post-2032). They underline the need to harmonise spatial planning tools with CAP objectives, particularly concerning land use, nature conservation, and infrastructure, in order to prevent conflicts between legislation and rural development strategies. The article also aims to analyse the challenges in implementing the environmental goals of the CAP, which are often inadequately fulfilled due to poorly designed eco-schemes and inconsistent funding. The article also includes a comparison of various EU member states’ approaches to CAP implementation.

In general, the collection and distribution of zakat fall under the responsibility and authority of the government. Efficient and effective zakat management contributes to improving the nation’s socioeconomic status, ensuring the well-being of the Muslim community, and reducing poverty. In the state of Johor, although the Johor State Islamic Religious Council (MAINJ) is the authorized body responsible for zakat collection and distribution, there remain zakat payers that make zakat payments privately, viz., directly to the asnaf rather than through officially recognized zakat institutions. This study aims to analyse analyse the factors that influence the private payment of zakat. The research was conducted in the Johor Bahru district, covering the mukim of Jelutong, Plentong, Pulai, Sungai Tiram, Tebrau, and the Johor Bahru urban area. The findings indicate that, in addition to paying zakat through MAINJ, some zakat payers also make direct individual payments to the asnaf, with one of the contributing factors being their level of knowledge concerning state zakat fatwas.

Abstract Despite being the EU’s largest budgetary instrument, direct payments remain allocated through political compromise rather than clear methodological criteria, sustaining long-standing disparities between EU-15, EU-10 member states, undermining solidarity. This paper proposes 18 models based on transparent rules to address this ambivalent situation. The developed 18 direct payments allocation models are based on objective indicators such as land prices, farm efficiency, and purchasing power. The proposed alternatives operationalise different fairness principles—equality, equity, cohesion. The evaluation of alternatives is conducted employing a multicriteria framework which balances distributive outcomes with political feasibility. The results show that hybrid approaches, combining flat-rate components with purchasing power or productivity adjustments, provide the most balanced outcomes between convergence, political sensitivity.

Background and Objectives: Vote-buying is a pervasive political phenomenon that undermines democratic principles, particularly in local governance structures. This study examines the deceptive vote-buying tactics employed by local politicians in rural Thailand, focusing on their impacts on democratic values, governance, and public morality. The research aims to analyze the mechanisms through which politicians manipulate the electoral process, the role of economic vulnerability in perpetuating vote-buying, and the long-term consequences for democratic development. Understanding these patterns is essential for formulating policy recommendations to combat electoral corruption and enhance political integrity. Methodology: The study employed a qualitative research approach, drawing from in-depth interviews, focus group discussions, and non-participant observations in four northeastern Thai provinces: Buriram, Surin, Si Sa Ket, and Ubon Ratchathani. The target participants include general voters, local politicians, community leaders, election officials, and youth representatives. Data collection focused on the types of vote-buying tactics used, public attitudes towards elections, and the societal implications of these corrupt practices. Additionally, secondary data from political science literature and electoral reports were analyzed to contextualize findings within broader theoretical frameworks. Main Results: The study revealed a multifaceted pattern of vote-buying strategies employed by local politicians in rural Thailand, reflecting a deeply entrenched culture of transactional politics. These tactics range from direct cash payments and the provision of consumer goods to false development promises, digital vote-buying via online transfers, and the mobilization of long-standing patronage networks. Economically vulnerable groups—particularly low-income households and the elderly—are systematically targeted due to their heightened dependency on state assistance and limited political agency. Beyond material inducements, coercive measures such as threats to withhold welfare benefits are deployed to manipulate voter behavior. Notably, the normalization of such practices within rural communities has blurred the moral boundaries between legitimate campaigning and corrupt exchange. Vote-buying is often perceived not as an act of electoral malfeasance but as a socially accepted reciprocity. This perception contributes to the erosion of democratic values, diminishes political accountability, and perpetuates a cycle of ineffective and self-interested governance. Discussions: The research underscores the ethical implications of vote-buying, demonstrating its role in eroding democratic values and public trust in governance. The practice reinforces systemic corruption, weakens political accountability, and prioritizes personal financial gain over genuine policy-driven governance. Moreover, vote-buying perpetuates a cycle of ineffective leadership, as politicians who attain power through financial incentives often seek to recoup their expenditures rather than fulfill campaign promises. Institutional weaknesses, including ineffective enforcement mechanisms by the Election Commission of Thailand, further enable these corrupt practices to persist. Conclusions: Vote-buying poses a significant threat to democratic integrity, particularly in local political systems where patronage networks are deeply entrenched. Addressing this issue requires comprehensive legal reforms, stronger law enforcement, and increased political literacy among citizens. Strengthening civic engagement and fostering a political culture based on transparency and accountability are critical for reducing electoral corruption. By implementing systemic changes and raising awareness about the detrimental effects of vote-buying, Thailand can move towards a more equitable and democratic electoral process.

BackgroundThe Democratic Republic of the Congo has introduced free maternal halthcare to reduce direct payments made by households. This initiative may lead to an increase in the demand for maternal services, which could put significant pressure on healthcare providers. This study aimed to assess the workload of midwives and to estimate the pressure it exerts on these providers in this context.MethodsWe conducted a cross-sectional study of 13 primary healthcare facilities in four health zones in the city of Kananga, including six first-level healthcare facilities and seven second-level healthcare facilities. The workload of midwives was assessed via the Workload Indicators of Staffing Need approach.ResultsThe basic services provided by midwives included childbirth, antenatal care, postnatal care and family planning. The results show that, in the seven first-level healthcare facilities, the number of midwives available was 20, whereas the actual need was 42, a shortfall of 22 agents. In the six second-tier healthcare facilities, 28 midwives were in post, whereas the calculated requirement was 35, a difference of 7 agents. Although some hospitals had a relatively balanced workforce, high average pressure (WISN ratio of 0.62) was reported for all hospitals studied. This pressure is moderately high in second-tier healthcare facilities (WISN ratio of 0.80) and very high in first-level healthcare facilities (WISN ratio of 0.48). All the primary healthcare facilities studied had only 44.8% of the midwives needed to provide free maternity services.ConclusionsThe results of this study reveal a marked shortage of midwives in eight healthcare facilities. Five healthcare facilities currently have sufficient staffing levels, which highlights the relevance of extending the analysis to other facilities to assess the potential for a redistribution of human resources. Such an adjustment would help balance the workload and enhance the effectiveness of free maternal healthcare.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-025-13656-y.

Abstract Impact evaluation design and implementation require technical and methodological skills and funding. If the interest is in bridging the research–practice gap and mainstreaming its recommendations into decision‐making, then impact evaluations will require collaboration among researchers, practitioners, and funders. In 2020, Switzerland began applying impact evaluations to assess conservation and sustainable development outcomes in Swiss parks of national importance. Four years later, we count four impact evaluations on park effects. While three studies focus on the park effect on ecological compensation areas, turnover/business efficiency, direct payments, and farm income, one study compares the effect of park status on perceived landscape quality. Plans to design and implement further studies exploring the park effect are underway. In this paper, we present the main opportunities and challenges encountered during the design and implementation of these evaluations. Against this background, we emphasize that collaboration is key to mainstreaming impact evaluation into practice. This paper offers suggestions for fostering such collaboration across various stages of the impact evaluation process, including technical capacity, data collection, and funding.

Over-indebtedness is at an all-time high in Sweden. The purpose of this study was to examine the relationships between financial literacy, coping strategies, and consumer financial behaviour. A further aim was to examine gender differences in this context. The study employed a cross-sectional survey design, in which participants (n = 2057) responded to questions related to the study variables. The results of the analysis found a significant relationship between financial literacy, problem-focused coping, and direct payment. Alongside this, the results revealed a significant relationship between financial illiteracy, avoidant coping, having consumer loans, and deferred payment strategies. Men were more likely to have consumer loans and to choose credit payment. Women were more likely to choose the Buy-Now-Pay-Later option in comparison to men. The findings of the present study can provide valuable insights on the psychological aspects of consumer financial behaviour. Additionally, it is recommended that financial literacy be continuously investigated as a potential “protective shield,” particularly in relation to psychological well-being, as well as in the context of the need for extended financial education.

While everyone, parents and non-parents alike, benefit from children, parents alone incur the cost of bearing and raising them. Johan Besterargues that, since society tasks parents with the labourious and financially burdensome task of raising children, and children are a social good, society has an obligation to help ease the burden of parenting by offering direct financial compensation to parents.While I agree that society should do much more to support parents, I am not convinced that the support should include direct financial payment to parents. After setting out Bester's arguments for this position and distinguishing it from a similar argument in political science, I offer a series of concerns: parenting is unlike socially beneficial employment-type work; Bester's argument may extend in problematic directions; financial incentives may harm the parent-child relationship; and there are other ways to promote parenting. Despite being critical, the purpose of this paper is to invite further discussion among bioethicists on how society can support parents in the important task ofparenting.

Background: This study examined the factors influencing out-of-pocket payments for healthcare services in public hospitals in the northern health district of Bujumbura, despite efforts to improve access to care. A descriptive and analytical survey was conducted with 124 patients using structured questionnaires. Descriptive analyses were supplemented with multinomial logistic regression. Purpose: The overall objective of this study is to analyze the factors associated with direct payment of health services in public hospitals; While, Specific objectives include: - Identify the associated factors with the use of out-of-pocket payments. - Evaluate reasons for non-enrollment in health insurance. - Identify the disadvantages of out-of-pocket payments for patients. Results: The results showed that 57.26% of patients paid directly for their care, 38.71% used health insurance, and 3.23% received free care. The main reasons for non-enrollment in health insurance included lack of information (38.81%), non-civil servant status (32.84%), and lack of funds for contributions (26.87%). As a result, 56.45% of patients experienced catastrophic out-of-pocket expenses, 30.65% had limited access to care, and 12.90% delayed treatment. Conclusion: The study highlighted the predominance of out-of-pocket payments, revealing financial challenges and inequalities in access to care. To reduce this dependency and improve equity, reforms were needed to make health insurance more accessible, increase awareness, and extend coverage to all Burundian citizens.

Introduction: The Open Payments Program (OPP) requires manufacturers to report payments to various entities involving physicians, aiming to increase transparency in industry-physician financial relationships. While general payments have been extensively studied, research payments, particularly those to non-covered entities (NCEs), remain poorly studied. Dermatology, a rapidly evolving specialty with significant industry-sponsored research activity, offers an ideal case to examine trends in research payments.Methods: This was a record-based longitudinal study using research payment data from dermatologists in 2015-2023 in the OPP database. Both direct research payments (payments directly to physicians) and associated research payments (payments to teaching hospitals and NCEs with physician principal investigators (PIs)) were included. Payments were inflation-adjusted to 2023 U.S. dollars using the Consumer Price Index for All Urban Consumers (CPI-U).Results: Between 2015 and 2023, 1,610 dermatologists received a total of $1.44 billion in research payments, with an average of 84% directed to NCEs with a dermatologist PI. Research payments to NCEs with a dermatologist PI declined from $161.0 million in 2015 to $107.6 million in 2023, but the overall trend was not statistically significant (p = 0.27). The top 10 NCE organizations received $179 million, with most being private institutions involved in pharmaceutical clinical trials. Four pharmaceutical companies accounted for nearly half of all research payments. Conclusion: Most research payments from the industry to dermatologists originated from a small number of pharmaceutical companies and were directed to NCEs, which have minimal reporting requirements. These findings underscore gaps in transparency within the OPP and highlight the need for new disclosure requirements regarding the distribution and use of funds to NCEs.

This article critically examines the role of the European Union’s Common Agricultural Policy (CAP) in shaping the development trajectory of rural areas in Bulgaria. Emphasis is placed on the evolution of CAP measures, their economic, social, and environmental impacts, and their contribution to the structural transformation of Bulgarian agriculture since EU accession. The analysis explores key policy instruments under Pillar I (direct payments) and Pillar II (rural development programmes), with a focus on modernization, competitiveness, sustainability, and demographic resilience. Drawing on strategic policy documents, statistical data, and comparative assessments, the study evaluates the extent to which CAP interventions have supported income stability, stimulated employment, enhanced biodiversity protection, and improved infrastructure in rural regions. Findings indicate that EU support has significantly increased farm productivity, diversified local economies, and strengthened environmental practices, although persistent structural challenges, such as land fragmentation, unequal distribution of subsidies, and demographic decline, continue to limit the full realization of rural development objectives. The article concludes by highlighting policy priorities and strategic directions for the post-2027 programming period, including digital transformation, targeted support for small and medium-sized farms, and stronger integration with cohesion and Green Deal policies.