Coal operations and cancer in the US: A systematic review.

Early involvement in the US criminal legal system (CLS) is linked to persistent health disadvantages, including reduced health insurance coverage in adulthood. The current study examined the influence of increases and cuts to federal and state Medicaid expenditures on health insurance enrollment among individuals with varying levels of CLS involvement before age 18. The current study is a cohort study of individuals who participated in the National Longitudinal Survey of Youth 1997 (2003-2021). The total sample included 8240 participants. This study applied Bayesian lagged random-intercept logistic regression to assess associations between Medicaid spending and uninsurance among individuals with and without CLS contact before age 18. Federal and State Medicaid expenditures were measured in total dollars spent by the federal government and state governments, respectively. Contact with the CLS before 18 was measured as arrested before 18, incarcerated in a juvenile facility before 18, or incarcerated in an adult facility before 18. Uninsurance was measured as the absence of insurance on the date of the interview. Greater CLS severity was associated with higher odds of being uninsured, while higher federal Medicaid expenditures were associated with a lower uninsurance rate. Simulations indicated that a 50% federal Medicaid spending cut could increase uninsurance for those with CLS involvement before 18, whereas a 20% spending increase would increase the probability of insurance. Findings highlight the federal Medicaid's role in mitigating coverage inequities and suggest that reducing expenditures could exacerbate ongoing health disparities rooted in early CLS involvement.

How Community Health Worker (CHWs) programs are governed shapes their performance. CHW governance can be challenged by CHWs' accountability to both governments and their communities, and the need to coordinate between multiple actors. Furthermore, little is known about how decentralization impacts CHW governance. We examined Nepal's Female community health volunteers (FCHV), where a 2015 constitutional change to federalism-a major governance reform representing one form of decentralization-shifted the responsibility for community health governance to local municipalities. We assessed FCHV governance in the federal landscape and provide preliminary insights into how federalization has impacted FCHV governance in its early years. We identified opportunities and challenges brought by federalization for six actors: federal, provincial and municipal governments, international donors, FCHVs and their representative organizations (unions), and non-governmental organizations. Our qualitative case study comprised 26 semi-structured interviews and five focus groups conducted with FCHVs, health workers, federal and municipal government representatives, researchers, and FCHV union, donor and NGO representatives, across four districts in Bagmati Province, combined with analysis of 259 documents. We analysed these data using a theoretical framework of CHW governance adapted from seven existing frameworks on health workforce and community health governance. We show that FCHV governance was characterized by improved accountability, transparency, participation, and responsiveness to local needs, to some extent. Decentralization remained incomplete, with governance challenged by limited budgetary and administrative decision-space at local levels, in part because of continued central-level control and limited revenue-raising capacity, coordination, and enforcement challenges, as well as lack of role clarity. While donors and NGOs participate in decision-making, FCHVs and their representative organizations are not consistently consulted. The results indicate that strengthening FCHV governance in federal Nepal will require capacity-building of municipalities while loosening the federal grip.

Tobacco remains the leading cause of preventable death in Australia, and although overall smoking has declined, rates remain much higher among disadvantaged populations. Thus, those most likely to be nicotine dependent are least able to afford cessation treatment. With strict limitations on duration of treatment and the range of products currently subsidised through the Australian Pharmaceutical Benefits Scheme, Australian Federal Government spending on tobacco addiction treatment falls well short of levels recommended by the World Health Organization, and best-practice interventions are not affordable for many patients. This is in stark contrast to far less prevalent addictions (e.g. heroin and opioids), for which people can receive heavily subsidised treatment for many years. Much greater investment in effective tobacco dependence treatments that is commensurate with the ongoing scale of harm caused by tobacco use would help the Australian Federal Government to meet its commitments to support Australians who smoke to quit, especially those belonging to disadvantaged population groups.

ABSTRACT The COVID-19 pandemic threatened to exacerbate an existing U.S. rental housing affordability crisis. In response, the federal government implemented the Emergency Rental Assistance Program (ERA), transferring nearly $47 billion to state and local governments to provide financial assistance to vulnerable renter households. Programs varied in several dimensions, including in novel policies, such as the use of self-attestation and proxies in lieu of documentation in applications. We merge household microdata from the Household Pulse Survey with data from state-level ERA programs to examine the relationship between policy variation and take-up of assistance. Using sequential logit models, we consider participation in a series of stages (application, decision, and receipt). Policies aimed at reducing administrative burdens and policies prioritizing specific groups were associated with increased likelihood of applications for and receipt of assistance, especially for the lowest-income households. Findings aid in understanding the unique policy regime of the pandemic and identify promising practices for post-pandemic assistance.

ABSTRACT Durable peace after internal armed conflict relies not only on silencing the guns but also on transforming combatants into constructive members of society. This article explores the rise of the Fano armed resistance in Ethiopia’s Amhara region following the Tigray war and examines this phenomenon through the lens of global disarmament, demobilisation, and reintegration (DDR) experiences. Drawing lessons from comprehensive international DDR programmes, the study advocates for an Ethiopian-led, negotiated reintegration strategy that directly addresses the distinct political, territorial, and security grievances fuelling Amhara’s unrest. The paper argues that abrupt, unilateral security restructuring without political consensus, such as the federal government’s disbandment of regional Special Forces, risks exacerbating instability. The analysis concludes with detailed policy recommendations rooted in comparative history and tailored to Ethiopia’s post-Tigray war circumstances.

ABSTRACT The United States was the world’s third-largest donor of climate change aid and the largest donor of foreign aid prior to 2025. As a major carbon emitter and donor, the U.S. has long been central to international climate change initiatives. However, details about U.S. climate aid are scattered and often difficult to interpret. This paper explores how the U.S. federal government structures its overseas climate change aid through a descriptive and thematic analysis of stated aims and objectives of 117 projects funded over a 25-year period (2000-2024), focusing on climate change adaptation. Using official government data, it investigates which forms and types of climate adaptation receive support, particularly in such areas as drought resilience, coastal protection, early warning systems, and climate-resilient agriculture, as well as the countries and institutions which are the main recipients of U.S. climate-related assistance. The analysis considers a range of adaptation-related interventions – from mangrove regeneration and erosion control to climate-resilient irrigation and glacial flood prevention. It goes beyond analysing only budgets, donors and implementation partners to evaluate project objectives and approaches, as well as the four thematic areas of gender, equity and justice, education, and displacement. By examining these themes, the study aims to provide a comprehensive overview of U.S. climate aid priorities and the evolving architecture of its international climate finance. It offers a descriptive thematic mapping of the stated aims, adaptation types, and cross-cutting priorities of 117 well-documented U.S. government-funded adaptation projects identified through official government data.

ABSTRACT After the fall of the Siad Barre regime, Somalia experienced a major power and security vacuum that enabled actors such as al-Shabaab to emerge as significant threats to both Somalia and the wider Horn of Africa. In response, the African Union deployed successive missions, including the African Union Mission in Somalia (AMISOM), the African Union Transition Mission in Somalia (ATMIS), and most recently the African Union Support and Stabilization Mission in Somalia (AUSSOM). However, military interventions alone cannot resolve Somalia's deeper governance crisis or eliminate al-Shabaab. This article argues that the main obstacle to achieving Somali-led security is political rather than military, due to the lack of sufficient domestic political unity to sustain coherent national security forces. The study evaluates the limits of externally supported security sector reform within Somalia's fragmented political environment and finds that without meaningful reconciliation between the Federal Government of Somalia (FGS) and the Federal Member States (FMS), the development of an effective Somali National Army (SNA) remains unlikely, thereby undermining the prospects of AUSSOM and future African Union missions.

ABSTRACT This study investigates how public policy capacity, institutional trust, and socio-demographic characteristics shape multiple dimensions of life satisfaction in the United States. Employing Hierarchical Linear Regression models, this study examines the effects of government policy instruments, including job-saving measures, reduction in length of work week, unemployment-related expenditures alongside trust in financial, economic, and public institutions, on happiness, work satisfaction, and financial satisfaction. The findings indicate that public spending on unemployment benefits, trust in business institutions, and trust in the federal government are positively associated with happiness. Work satisfaction is significantly influenced by employment protection policies, unemployment benefit expenditures, and trust in both business institutions and the federal government. Financial satisfaction is primarily determined by trust in financial institutions and federal governance capacity. Although socio-demographic characteristics display differentiated effects across life satisfaction domains, employment status and perceived social class consistently exhibit strong and positive associations with happiness, work satisfaction, and financial satisfaction.

Lessons Learned from a Hybrid Approach to Collecting User Feedback on Coastal Science Products.

When resources are scarce at crisis times and when competition is intense with other creative supplies, USA symphony orchestras and opera houses memorize and perform their repertoires (or repertories), so that seasons are crucially bundled between tradition and innovation. Since the beginning of the latest financial and real crisis (2007), USA classical music has seen different levels of funding from the federal government and businesses have encouraged more nonconventional programming (Pompe, Tamburri, 2016; Turbide, Laurin, 2009; Ravanas, 2008; Rushton, 2008; Turrini, 2006; Smith, 2007). On one side, fundraisers have stressed bundles (contemporary music with tradition) to sponsors; on the other side, marketing officers have emphasized the repertoire memory to audiences who constantly love Traviata, Boheme and Don Giovanni with echo of famous regisseurs, scenographers, etc. This is quite the same worldwide (Cancellieri, Turini, 2016). Fundraising and marketing affect economic performances of classical music, also thanks to social media and networks. Consumers have access to information about ticketing, rehearsals, present and past performances, etc. Art organizations strive to manage communication via social media to create brand values. Social media support both fundraising and marketing, as they mediate to sponsors and audiences: values, advocacy, videos and photos of the repertoire and nonconventional programming, which continually increase trustworthy relationships and nurture memories.This paper investigates 200 USA symphony orchestras and opera houses according to repertoires, revenues, expenses and gains in 2008 and 2015. With cluster analysis, three profiles emerge with different strategies, performances and emphasis on memory or innovation.

Structures, processes and outcomes for establishing a statewide infection prevention and control service for Queensland, Australia.

Gaining Compliance For an Ingredient to be Added to Food, Feed, and Dietary Supplements.

Cardiovascular diseases cause nearly one-third of global deaths, yet standalone National Cardiovascular Disease Control Plans remain uncommon and inconsistently structured. We assessed the comprehensiveness of recent national plans using a validated health-systems framework and a multi-agent artificial intelligence model. We identified the most recent official plan for 45 countries from World Health Organisation and World Heart Federation repositories and government sources. We adapted a health-systems planning framework for cardiovascular disease and validated it through a two-stage expert consensus process involving 42 specialists from 28 countries, resulting in 11 elements and 69 sub-elements with standardised definitions and scoring criteria. Plans were analysed using a three-stage artificial intelligence pipeline that ingested documents, applied framework-based scoring, and performed automated validation checks. Sub-elements were scored on a 0-5 scale and summarised by element, World Health Organisation region, and World Bank income group. Overall comprehensiveness was low (median 1.20/5). Plans most consistently addressed strategic direction (median 2.80) and governance arrangements (2.14). Contextual assessment was deficient - threats (0.12) and opportunities (0.29) - as were performance specification elements, including objectives (0.50) and health system outcomes (0.67). The Western Pacific region scored highest (median 1.71) and Africa lowest (0.90), though scores remained below moderate levels across all regions. Income group pairwise comparisons were non-significant across all groups; given the small LIC sample (n = 2), no inferential conclusions about income group differences are drawn. Validation against blinded human review across six countries showed 43.7%exact agreement and 68.0%agreement within one point; ordinal agreement statistics were uniformly weak and non-significant, indicating the approach is validated for structural benchmarking rather than fine-grained qualitative judgement. Most national cardiovascular disease plans articulate vision without sufficient operational detail, particularly for contextual analysis, measurement, and integrated financing. Standardised planning templates and artificial intelligence-supported benchmarking, complemented by expert review, could strengthen national planning quality and enable scalable global comparisons.

Hepatitis B, C, and D viruses (HBV/HCV/HDV) can cause chronic infections that lead to sequelae like liver cirrhosis and hepatocellular carcinoma (HCC). We aimed to estimate the fractions of cirrhosis and HCC attributable to HBV and HCV in Kyrgyzstan. We collected information on patients diagnosed with cirrhosis and/or HCC from medical records in clinical hospitals and oncology centres in Bishkek, Osh, and Jalalabad. The study included a prospective part from 08/2023 to 04/2024 and a retrospective part from 01/2019 to 07/2023. We calculated attributable fractions (AFs) with 95% confidence intervals (95% CI) for HBV and HCV and stratified results by age, sex, and region. We analysed test results for HBV surface antigen (HBsAg), antibodies to HCV (anti-HCV) and HDV (anti-HDV), and viral DNA/RNA. Among participants with cirrhosis, we found AFs of 46% (95% CI 42-49%) for HBV (416/914) and 25% (95% CI 22-28%) for HCV (226/914). Among participants with HCC, AFs to HBV (182/572) and HCV (183/572) were both 32% (95% CI 28-36%). These calculations included 3% of cirrhosis (25/914) and HCC (17/572) patients who had HBV/HCV-coinfections. Among participants tested for anti-HDV, 78% (306/390) of cirrhosis patients and 50% (44/88) of HCC patients tested positive [for anti-HDV]. Large fractions of cirrhosis and HCC cases were attributable to HBV and HCV, with HBV/HDV-coinfections being common. To prevent long-term sequelae and to eliminate viral hepatitis as a public health threat in Kyrgyzstan, earlier testing and treatment options should be implemented. This study received financial support in the framework of the Global Health Protection Programme by the Federal Government of Germany.

In 2019, five Inuit from Iglulik, Nunavut, sued the federal government for medical experiments, including painful skin grafts, conducted on them in the 1960s and 1970s. From 1968 to 1972, researchers – academics, dentists, and physicians employed by Canadian universities and government – arrived in two Nunavut communities to study the Inuit. As part of the International Biological Programme (ibp), they engaged with a transnational scientific construction of the world’s Indigenous peoples as “primitives” who were assumed to embody the secrets of human evolution and adaptation. Research would reveal those secrets for the “civilized” world seemingly on the brink of environmental destruction. In return for the promise of needed health care, the community councils agreed to cooperate with researchers who then took away blood, tissue, teeth, x-rays, personal data, photographs, and at least one child. John Dossetor, who directed the skin graft experiments, was subsequently hailed as a pioneer in medical ethics and memorialized in the University of Alberta’s medical ethics centre. This article argues that the ibp experiments indulged professional interests and advanced careers while implicating the developing field of bioethics in colonial violence.

Malnutrition is prevalent among aged care residents and is exacerbated by inadequate provision and intake of protein. High rates of malnutrition and inadequate provision of protein were two issues raised by the Royal Commission into Aged Care Quality and Safety that prompted the Federal government to provide financial support to the sector to improve nutrition in residents. We aimed to determine if protein provision to, and intake in, residents has improved and meets requirements following the Royal Commission. Protein intakes from 12 Pre-Royal Commission studies were identified from a literature search (n = 2378 residents, 85.9 years, 72.3% female). Post-Royal Commission intakes of 78 residents (84.3 years, 84.6% female) were documented. Protein intakes were measured using weighed intake or visual plate waste assessment over 1-3 days. Intakes (±95% confidence interval) for protein (g), relative protein (g/kg body weight), high-protein foods and energy (kJ/kg body weight) were calculated. Differences occurred if the 95% confidence interval between Pre- and Post-Royal Commission intakes did not overlap. Mean relative protein (0.9 g/kg body weight; 95% confidence interval: 0.8-0.9) and energy (98 kJ/kg body weight; 95% confidence interval: 97-100) intakes of residents pre-Royal Commission did not differ to post-Royal Commission residents (protein: 0.9 g/kg body weight; 95% confidence interval: 0.8-1.0, energy: 96 kJ/kg body weight; 95% confidence interval: 88-104). Provision and intakes of high-protein foods remained below recommended levels. Protein intake of residents and provision of high-protein foods were inadequate prior to and remain below recommendations since the Royal Commission. Regulatory changes such as minimal national nutritional standards for food provision are required to ensure nutritional adequacy of aged care residents.

Science and technology education research plays a fundamental role in real economic growth and transformation, wealth creation and improvement of quality of life in any nation. Based on this premise this study examines the concept of science and technology education; research driven economy and its role in accelerating the implementation of the Federal Government Renewed Hope Agenda at the different segments of economy such as, healthcare delivery, water supply, environmental management, transportation, security and safety, poverty alleviation, agriculture, rural development, food security, clean and affordable energy and education. The study observed that the gap between developed and underdeveloped countries can largely be attributed to differences in science and technology education, research and development and the difficulty in their application. When properly harnessed, education, research and development synchronously represent a triple helix for advancing the frontiers of sub-national and national development. The study recommends that concrete steps could be taken to create the needed environment for research activities in the country by government. The provision of basic infrastructure and facilities, which goes hand in hand with increased budgetary allocation to the educational sector and research specifically, has become imperative.

The plastic pollution resulting from single-use bottled water contributes to global environmental, economic, and health issues. Reducing use requires communication strategies tailored to consumer behavior. This study tested a conceptual model examining the influence of trust in the federal government, perceived risk of tap water, organoleptic qualities, and attitudes toward single-use bottled water on intentions to purchase or use it. All variables showed significant effects on intention to use single-use bottled water. Unexpectedly, trust in the federal government had a small but positive effect on both attitudes toward and intention to use single-use bottled water. This result may reflect public misunderstanding or limited awareness of which agencies regulate tap water, as well as the influence of broader media narratives. The findings underscore the need to improve public understanding of tap water governance. To reduce reliance on single-use bottled water, communication efforts and infrastructure improvements must address both perceived safety and organoleptic qualities of tap water.

ABSTRACT This paper examines the impact of decentralization and partial financing of healthcare through local governments (Panchayats) in India on the health status and income of household members. We construct a healthcare and illness dataset from the nationally representative Rural Economy and Demography Survey (REDS) which is comprised of 14,841 adults from 238 villages. Using this dataset, we examine how various forms of decentralization affect the health status, health-seeking behaviour, and welfare of village residents. Choice of public healthcare is shown to have higher welfare impacts compared to other forms of healthcare providers and the out-of-pocket health expenditures. We show that individuals react not only to the supply-side measures by federal and state governments, but also to mechanisms of decentralized health governance. We also demonstrate that efficient choices concerning healthcare made by household members contribute significantly to the village-level economic activity. The traditional instrumental variable estimates are robust to post-double-selection LASSO specifications.