Limited Policy Research Articles

Working after cancer: in-depth perspectives from a setting with limited employment protection policies.

A considerable proportion of individuals who are diagnosed with cancer are at a working age. We aimed to gain an in-depth understanding of the challenges, and arising needs related to working after cancer in a setting with limited employment protection policies. Focus group discussions were conducted with cancer patients who were diagnosed at least 1 year prior to recruitment, and either had paid work, were self-employed, currently unemployed, or currently retired (N = 66). Three main themes were identified: (1) loss of income: While some participants were entitled for a 1-year cancer-specific sick leave, many other participants recounted having insufficient paid sick leave, forcing them to take prolonged unpaid leave to complete treatment; (2) dealing with side effects of cancer and its treatment: The need for workplace accommodations was highlighted including flexible working hours, lighter workloads, and dedicated rest areas to enable patients to cope better; (3) Discrimination and stigma at workplace: Some participants mentioned being passed over on a promotion, getting demoted, or being forced to resign once their cancer diagnosis was disclosed, highlighting an urgent need to destigmatize cancer in the workplace. In settings with limited employment protection policies, a cancer diagnosis severely impacts the working experiences of patients, leading to financial loss. Urgent interventions and legislative reforms are needed in these settings to address the unmet employment needs of cancer survivors. This study may facilitate planning of local solutions to fulfill the unmet employment needs following cancer, such as return-to-work navigation services.

Medicaid prescription limits and their implications for naloxone accessibility

BackgroundExpanding access to and utilization of naloxone is a vitally important harm reduction strategy for preventing opioid overdose deaths, particularly in vulnerable populations like Medicaid beneficiaries. The objective of this study was to characterize the landscape of monthly prescription fill limit policies in Medicaid programs and their potential implications for expanding naloxone use for opioid overdose harm reduction. MethodsA cross-sectional, multi-modal online and telephonic data collection strategy was used to identify and describe the presence and characteristics of monthly prescription fill limit policies across state Medicaid programs. Contextual characteristics were described regarding each state’s Medicaid enrollment, opioid prescribing rates, and overdose death rates. Data collection and analysis occurred between February and May 2020. ResultsMedicaid-covered naloxone fills are currently subject to monthly prescription fill limit policies in 10 state Medicaid programs, which cover 20 % of the Medicaid population nationwide. Seven of these programs are located in states ranking in the top 10 highest per-capita opioid prescribing rates in the country. However, 8 of these programs are located in states with opioid overdose death rates below the national average. ConclusionsMedicaid beneficiaries at high risk of opioid overdose living in states with monthly prescription fill limits may experience significant barriers to obtaining naloxone. Exempting naloxone from Medicaid prescription limit restrictions may help spur broader adoption of naloxone for opioid overdose mortality prevention, especially in states with high opioid prescribing rates. Achieving unfettered naloxone coverage in Medicaid is critical as opioid overdoses and Medicaid enrollment increase amid the COVID-19 pandemic.

State TANF Time Limit and Work Sanction Stringencies and Long-Term Trajectories of Welfare Use, Labor Supply, and Income.

While the 1996 welfare reform increased employment and reduced the participation of the Temporary Assistance for Needy Families (TANF) program immediately after its inception, little is known about the extent to which the reform and stringencies of time limit and work sanction policy features have impacted individuals in the long term. This study used the Survey of Income and Program Participation 1996, 2001, and 2004 panels (1996–2007) and a difference-in-difference-in-difference design to follow low-skilled single mothers’ trajectories of welfare use, labor supply, and income for 10 years after the welfare reform and compare how these trajectories differ by stringencies of state work sanction and time limit policies. The findings indicate that welfare reform had sustained impacts on reducing welfare use (TANF and the Supplemental Nutrition Assistance Program [SNAP] program) and increasing employment. Stringent work sanction and time limit policies were associated with lower TANF participation rates in the long term, but only short time limit policies were associated with reduced SNAP participation. Neither stringent policy feature increased employment nor income. The differential effects by race were also examined and discussed.

Korean webtoons and collective innovation: expanding Europe's creative industries through competitive localization

This study investigates the rise of South Korea’s webtoon industry and the fan–translators who are contributing to the transformation of this entrepreneurial digital comics format. By analyzing the creator-owned thriller series Bastard (2014 –) and its various foreign-language versions, the authors demonstrate how cultural intermediaries are localizing content and cultivating new audiences through a process of 'collective innovation'. The characteristics of this crowd-sourced activity offer new understanding of the dynamics and potential impacts of this digital comics industry, which is rapidly transforming with only limited policy intervention. The study illustrates how the French digital comics platform Delitoon is attempting to compete in this Korean-dominated domain, raising questions for enterprises seeking to join this popular wave of digital media. In doing so, this study fosters debate for business managers, policymakers, and practitioners in Europe’s creative industries who are developing and promoting creator-owned content while challenging protectionist boundaries.

Implementation of Large-Scale Social Restrictions Policy (PSBB) in Bogor District Government

Large-scale Social Limitation (hereinafter referred to as PSBB) is one form of concern. The government and local governments are Pendemic throughout Indonesia and the world, namely Pandemic Corona Virus Disease (Covid-19). Bogor Regency, which is one of the buffer cities of the Republic of Indonesia, is an area that is quite vulnerable in spreading the Corona virus. Why? because many DKI Jakarta employees / laborers live in Bogor Regency, whose mobility is very high. With the birth of Regent Regulation No. 16 of 2020 concerning Implementation of Large- Scale Social Restrictions in Handling COVID-19 in order to conserve the use of Covid 19. The purpose of this study is to analyze the Implementation of Large Scale Social Limitation Policies in the Government of Bogor Regency. This research method uses Qualitative Methods with Literature Study research methods. (Huberman, Miles, 1994). The technique of inviting data is by searching Scientific Journals, Online Mass Media, Legislation and Books. The technique to determine Online Media by Pusposive, while for data analysis using Nvivo 12 Plus. Test the validity of the data by testing the data source. The results of the study show that the implementation of the Large-Scale Social Limitation Policy in the Bogor District Government has not yet proceeded, starting from the clash of authority between the Central Government and the Regional Government so that it cannot make improvements, and many more are in accordance with the provisions of Covid-19 and its distribution. Social assistance to the community.

Signifikansi Pengaruh Sentimen Pemberlakuan PSBB Terhadap Aspek Ekonomi: Pengaruh Pada Nilai Tukar Rupiah dan Stock Return (Studi Kasus Pandemi Covid-19)

The Large-Scale Social Limitation Policy (Pembatasan Sosial Berskala Besar/PSBB) was chosen by the Indonesian government in responding to the pandemic covid-19. The PSBB policy is preferred by the government to be implemented instead of lockdown. Much controversy in public over the PSBB policy has built the sentiment. Consideration of the economic aspects has been the main reason in making these policies. With consideration of the state of the Indonesian economy, the government believes that this policy is an effective and efficient pathway with a note that the public will be able to conduct pandemic covid-19 health protocol discipline and form herd immunity. This study aims to evaluate the effect of the implementation of the PSBB which has an impact on public sentiment fluctuations, using secondary stock return data on blue-chip stocks and the rupiah exchange rate in the range of time before and after the implementation of the PSBB begun, April 10, 2020. Wilcoxon test is used as data analysis tool of nonparametric statistics. The test results stated that the exchange rate of the rupiah against the US dollar was significantly affected by public sentiment towards the implementation of the PSBB, while the stock return was not significantly affected. Several factors beyond the implementation of PSBB need to be considered in influencing stock returns as well as the rupiah exchange rate.

Sweetening Agents and Sweeteners in Dietary Supplements for Children-Analysis of the Polish Market.

Sweetening agents (SA) and sweeteners are major additives used in the production of dietary supplements (DS), they fulfill both technological and organoleptic functions. The aim of this study is to identify the types of SA and sweeteners found in DS intended for children and to determine the secondary role of them. The study was performed on data from the documentation of representative samples of DS (N = 315) available on the Polish market. The results show that 75.24% of the products contained at least one SA or sweetener. Sucrose is the SA most frequently used in DS production. The empirical findings show that the type of sweetening ingredient correlates closely with the formulation of products, which in turn has to be suited to consumption abilities of the target group as well as to the children’s taste requirements. The crucial need for analysis of the composition of DS is emphasized in the light of high consumption rates of these products as well as limited regulations and policy.

A homeownership paradox: why do Chinese homeowners rent the housing they live in?

China is an ownership society, but with a paradox – many homeowners do not live in the apartments/houses they own, and instead live in rental housing. This is different from the pattern in Western economies where households own multiple properties but still live in an owned unit. The paper is situated within the literature on the financialization of housing and the changing meaning of homeownership. We examine the paradox by studying its patterns and dynamics using 2017 China Household Finance Survey data. We find that the owner-renting in China is a result of spatial, temporal and functional mismatches between housing needs. The intrinsic investment strategy and services linked to homeownership have made it imperative to own homes, regardless a household’s housing needs. Young, single, better-off and split households, and those in large, expensive cities are more likely to be owners-renting. In addition, institutional barriers in the housing market such as migrant status, housing purchase limit policy, and subsidized housing encourage owner-renting.

When is SARS-CoV-2 in your shopping list?

The pandemic of coronavirus disease 2019 (COVID-19) has caused several million confirmed cases worldwide. The necessity of keeping open and accessible public commercial establishments such as supermarkets or pharmacies increases during the pandemic provided that distancing rules and crowd control are satisfied. Herein, using agent-based models, we explore the potential spread of the novel SARS-CoV-2 considering the case of a small size supermarket. For diverse distancing rules and number of simultaneous users (customers), we question flexible and limited movement policies, guiding the flow and interactions of users in place. Results indicate that a guided, limited in movement and well-organized policy combined with a distance rule of at least 1 m and a small number of users may aid in the mitigation of potential new contagions in more than 90% compared to the usual policy of flexible movement with more users which may reach up to 64% of mitigation of potential new infections under the same distancing conditions. This study may guide novel strategies for the mitigation of the current COVID-19 pandemic, at any stage, and prevention of future outbreaks of SARS-CoV-2 or related viruses.

Economic evaluations of big data analytics for clinical decision-making: a scoping review.

ObjectiveMuch has been invested in big data analytics to improve health and reduce costs. However, it is unknown whether these investments have achieved the desired goals. We performed a scoping review to determine the health and economic impact of big data analytics for clinical decision-making.Materials and MethodsWe searched Medline, Embase, Web of Science and the National Health Services Economic Evaluations Database for relevant articles. We included peer-reviewed papers that report the health economic impact of analytics that assist clinical decision-making. We extracted the economic methods and estimated impact and also assessed the quality of the methods used. In addition, we estimated how many studies assessed “big data analytics” based on a broad definition of this term.ResultsThe search yielded 12 133 papers but only 71 studies fulfilled all eligibility criteria. Only a few papers were full economic evaluations; many were performed during development. Papers frequently reported savings for healthcare payers but only 20% also included costs of analytics. Twenty studies examined “big data analytics” and only 7 reported both cost-savings and better outcomes.DiscussionThe promised potential of big data is not yet reflected in the literature, partly since only a few full and properly performed economic evaluations have been published. This and the lack of a clear definition of “big data” limit policy makers and healthcare professionals from determining which big data initiatives are worth implementing.

Perceived Challenges for Rural Gifted Education

Rural communities and school systems are the heart of many states across the nation. Yet, many of the challenges facing rural gifted education remain unanswered. There is limited research or policy focused on gifted students, teachers of the gifted, or gifted programming in rural settings. Understanding how culture defines rural communities and influences educational decisions is key in overcoming challenges within gifted programs. This study seeks to explore some of the perceived challenges and the influence of rural culture in providing gifted services in four rural school districts in Texas. Findings highlight the struggles of rural gifted programs to identify and serve gifted students. These struggles fall into three categories: limited funding, limited time, and limited resources available for gifted programs.

What is “fair and reasonable”? Norms and strategies guiding the distribution of assets by testators who have an adult child with intellectual disability

ABSTRACT Background: Parents making a will most commonly distribute assets evenly to adult children. How parents of an adult child with an intellectual disability use wills to plan for future care and support has had limited policy, practice and research attention. Method: This research reports on the perceptions of 20 parents regarding the impact of the needs of their child with disability on estate planning. The participants were purposively recruited and interviewed during 2014–15. Results: Participants were more likely to consider equity of outcomes for their children taking into account retaining access to state services. They report difficulties in future planning in the context of changing service systems and limited specialised advice. Conclusions: Judgements about what is fair and reasonable in distributing assets reflect differing views of need and entitlement within families. Such families would benefit from specialised advice and support in estate planning, particularly given the changing context.

OVERMACHT: ANALISIS YURIDIS PENUNDAAN PELAKSANAAN PRESTASI AKIBAT PANDEMI COVID-19

On March 14, 2020, the government of the Republic of Indonesia announced the Covid-19 pandemic as a National Disaster. The whole community was asked to stay at home or work from home. This situation caused the daily activities of the community and government from school, work, trade, and others to become ineffective and delayed. This also affects all national and global corporate activities. Many business entities are disrupted due to the Large-Scale Social Limitation policy, so the company or a person cannot keep their promises as made in the previous agreement. This study examines whether Pandemic Covid-19 can be used as a reason for a person or a company to postpone the performance of achievements because it is considered as an overmacht, and how the legal force. This is a qualitative-library research using a juridical-normative approach. The results showed that overmacht is equated with the term force majeure meaning the state of force, in this case the debtor cannot be held accountable, because the situation occurs outside his control and not because of an element of negligence. The state of overmacht is regulated in the provisions of Article 1244 and Article 1245 of the Civil Code. The Covid-19 pandemic is considered as a forced condition, including the overmacht category, so that it can be used as an excuse for debtors to postpone or not carry out performance according to the agreement, provided that the debtor is able to provide reasons that the failure to fulfill the agreement is not because of them, but because something cannot be predictable, and inevitable.

The impact of shale gas development on the U.S economy: Evidence from a quantile autoregressive distributed lag model

The advent of shale gas in economically and commercially viable scale has changed the dynamics of the U.S energy profile making it a net exporter of natural gas. However, despite the growing importance of shale gas, its impact on the economy of US has not been substantially investigated. This creates gaps in the empirical literature of energy economics with limited policy guides for the policy makers and other relevant stakeholders. This paper therefore contributes to the extant literature by examining the impacts of shale gas on economic expansion in the U.S in an augmented framework that includes capital stock and labour as additional variables. With quarterly dataset that covers the period, 2002Q1 to 2019Q1, we employed Cho et al. (2015) [1]’s Quantile Autoregressive Distributed Lag (QARDL) modelling technique to probe the long run relationships between the variables. The results confirm a long-run significant impact of shale gas and capital stock on economic growth of U.S while labour force is found to be a positive but not significant factor in economic growth of the U.S. Investment in capital infrastructure that can enhance the technology of natural gas extraction and fracking is recommended for full optimization of the shale gas consumption. Concerted efforts should also be made, through research and development, to improve the efficiency of labour force.

The Advertising Policies of Major Social Media Platforms Overlook the Imperative to Restrict the Exposure of Children and Adolescents to the Promotion of Unhealthy Foods and Beverages.

There have been global calls to action to protect children (aged <18) from exposure to the marketing of unhealthy foods and beverages (‘unhealthy foods’). In this context, the rising popularity of social media, particularly amongst adolescents, represents an important focus area. This study aimed to examine the advertising policies of major global social media platforms related to the advertising of unhealthy foods, and to identify opportunities for social media platforms to take action. We conducted a desk-based review of the advertising policies of the 16 largest social media platforms globally. We examined their publicly available advertising policies related to food and obesity, as well as in relation to other areas impacting public health. The advertising policies for 12 of the selected social media platforms were located. None of these platforms adopted comprehensive restrictions on the advertising of unhealthy foods, with only two platforms having relevant (but very limited) policies in the area. In comparison, 11 of the 12 social media platforms had policies restricting the advertising of alcohol, tobacco, gambling, and/or weight loss. There is, therefore, an opportunity for major social media platforms to voluntarily restrict the exposure of children to the marketing of unhealthy foods, which can contribute to efforts to improve populations’ diets.

0196 Differences in Sleep Duration and Alertness Among Internal Medicine Interns Comparing Intensive Care Unit to General Medicine Rotations: A Secondary Analysis of the ICOMPARE Trial

Abstract Introduction Little is known about the impact of specific rotations on medical residents’ sleep. The purpose of this analysis was to examine the difference in sleep duration and alertness among internal-medicine resident interns during intensive care unit (ICU) compared to general medicine (GM) rotations. Methods This is a secondary report of a randomized non-inferiority trial of 63 United States internal-medicine residency programs. Programs were assigned to either standard duty-hour (80h workweek/16h shifts) or flexible (80h workweek/no shift-length limit) policies. Interns were followed for 2 weeks during either a GM or ICU rotation. The primary outcome was sleep duration/24h (actigraphy). Secondary outcomes were sleepiness (Karolinska Sleepiness Scale [KSS]) and alertness (number of Brief Psychomotor Vigilance Test [PVT-B] lapses). Data were averaged across days (thirteen 24-hour periods). Linear mixed-effect models with random program intercept were used to determine the association between each outcome by rotation, controlling for age, sex, and policy followed. Results N=386 interns were included (mean age 27.9±2.1y, 194 (50.3%) males), with n=261 (67.6%) in GM, and n=125 (32.4%) in ICU. Average sleep duration was 7.00±0.08h and 6.84±0.10h for GM and ICU respectively (p=.09; 95%CI -0.02;0.33h). Percent of days with self-reports of excessive sleepiness were significantly more likely for ICU vs GM from 12am-6am (ICU: 20.2%; GM: 12.5%) and 6am-12pm (ICU: 20.5%; GM: 14.3%). GM had significantly more days with no excessive sleepiness (GM: 40.5%; ICU: 28.1%). Average KSS was 4.8±0.1 for both GM and ICU (p=.60; 95%CI -0.18;0.32). Average number of PVT-B lapses were 5.5±0.5 and 5.7±0.7 for GM and ICU respectively (p=.83; 95%CI -1.48;1.18 lapses). There were no significant differences in PVT-B response speed or false starts between rotations. Conclusion Interns in ICU may experience more excessive sleepiness compared to GM interns, especially in early morning hours. However, sleep duration and alertness were not significantly different between rotations. Support Funded by the National Heart, Lung, and Blood Institute and American Council for Graduate Medical Education

Environmentally sustainable transitions of US district energy systems: Perspectives from infrastructure operators/designers through the co-evolutionary lens

Advanced district energy systems can improve local sustainability through reducing energy used for heating and cooling buildings. However, district energy systems (DESs) and their transitions are overlooked by US communities in their sustainable agendas. This research applied the multi-level perspective and co-evolutionary framework to investigate DESs' transition context and niche level practices from DES operators'/designers' perspectives. Document review approach was adopted to delineate DESs' transition context. Fourteen semi-structured interviews were conducted to investigate DES operators'/designers' visions and how they interact with factors related to ecosystems, technology, institutions, and users for near-term transitions. This research found that DESs in the US served about 10% and 12% of fully air-conditioned floor space for heating and cooling, respectively. About 93% of services provided by DESs in the US were powered by fossil fuels, and 79% of DESs distributed steam. Current federal and state policies play limited role in promoting DESs, while local policies can only encourage niche-level innovations. Results from interviews demonstrated that DES operators/designers foresaw that DESs would move toward the advanced ones. DES operators/designers were motivated by the users’ demand and emerging local policy preferences to take action. Thus, DES operators/designers emphasized the importance of working closely with users and policymakers, engaging potential customers, and tapping into technical expertise during the process of transition. These results indicate that DES operators/designers took on many responsibilities with limited policy and market support. With low pressure to select DESs as a key sustainability tool at the regime level, the sustainable transition of DESs in the U.S. may only remain at the niche level.

Policy Adoption and Policy Intensity: Emergence of Climate Adaptation Planning in U.S. States

AbstractThe United States is experiencing growing impacts of climate change but currently receives a limited policy response from its national leadership. Within this policy void, many state governments are stepping up and taking action on adaptation planning. Yet we know little about why some states adopt State Adaptation Plans (SAPs), while others do not. This article investigates factors that predict the emergence of SAPs, both in terms of policy adoption and policy intensity (goal ambitiousness). Applying the diffusion of innovation theory, I consider the relative influence of internal state characteristics, regional pressures, and test for conditional effects between government ideologies and severity of the problem. The results show interesting differences between predictors that influence policy adoption and ambitiousness. States are more motivated to adopt a policy when faced with greater climate vulnerability, have more liberal citizenry, and where governments have crossed policy hurdles by previously passing mitigation plans. The intensity of policies and goal setting, moreover, is more likely to be driven by interest group politics and diffuse through policy learning or sharing information among neighboring states in Environmental Protection Agency regions. These findings support an emerging scholarship that uses more complex dependent variables in policy analysis. These variables have the potential to differentiate symbolic from substantive policies and capture finer information about predictors of importance.

IMF Managing Director's Statement to the Development Committee, April 2020

The global coronavirus outbreak is a crisis like no other and poses daunting challenges for policymakers in many emerging market and developing economies (EMDEs), especially where the pandemic encounters weak public health systems, capacity constraints, and limited policy space to mitigate the outbreak’s repercussions. A severe economic impact in the first half of 2020 is inevitable. Medium-term projections are clouded by uncertainty regarding the pandemic’s magnitude and speed of propagation, as well as the longer-term impact of measures to contain the outbreak, such as travel bans and social distancing. However, most EMDEs are already suffering from disruptions to global value chains, lower foreign direct investment, capital outflows, tighter financing conditions, lower tourism and remittances receipts, and price pressures for some critical imports such as foods and medicines. Commodity exporters have to absorb, in addition, a sharp decline in export prices, notably for oil. Further, in most countries, the coronavirus outbreak is producing unanticipated health spending needs and revenue losses as activity slows. Coping with these challenges is especially difficult for countries with limited administrative capacity, tight external financing constraints and/or already high debt levels, and thus requires substantial support from the international community.

Mekong River Delta Agricultural Mechanization Development: Case Study in Vinh Long Province, Viet Nam

Agricultural mechanization is an essential path to the industrialization of rural regions. Viet Nam has more than 40% of the population in the agriculture sector, contributing nearly 30% of the country’s GDP and still is an agricultural country. Mekong River Delta (MRD) is the most significant agriculture production region of Viet Nam in which Vinh Long is one of sample province might be representative for MRD. This paper presents case study of recent status of mechanization in agriculture, and some recommendations for development the agricultural mechanization in the province. The statistical methods, SWOT analysis, problem approach and practical research have been used. The results indicate that the ratio of agricultural mechanization in Vinh Long might be not to satisfaction to the development of agriculture production. The agricultural field using walking tractors and shoulder engines, investment and financial policies, skill and training level of farmers and agricultural infrastructure such as rural transportation system, irrigation system, and agricultural production industrial processing are the main factors strongly influence on the development of agricultural mechanization in Vinh Long. Some studies proposed recommendations as solutions for sustainable development of the agricultural mechanization are presented in this study, such as agricultural production needs to be reorganized; developing system for training high quality and skill people to work in mechanization process; increase investments in science and technology for agricultural mechanization; setting up the policies to attract businesses and individuals invest in developing mechanization; removing blockages on "agricultural land limit" policy; and creating financial policies supporting to agricultural production investors.