Pilot Program Research Articles

How does e-commerce development affect county-level CO2 emissions: New evidence from 2,142 counties in China

Existing literature continues to present divergent perspectives regarding how e-commerce development influences CO2 emissions. The China’s county-level e-commerce pilot program provides new evidence for researches in this subject. This study investigates the effects of China’s rural e-commerce development on CO2 emissions using panel data in 2,142 counties from 2010 to 2021, as well as a staggered Difference-in-Differences (DiD) model based on the "Rural E-commerce Demonstration Counties " (REDC) pilot program. Considering the REDC preference towards poor areas, this paper adds the selection variable of pilot program into the model. The main purpose of the REDC is to foster e-commerce growth, but this study finds that the pilot program inadvertently significantly reduces county-level CO2 emissions while promoting GDP growth in the county. The pilot program of e-commerce mainly achieves carbon reduction through two channels: encouraging the servitization of county industrial structures and the digital transformation of traditional industries. Emissions reductions have a greater impact on economically developed places, provinces with a stronger basis in e-commerce, and counties with better mobility options. This study accurately assesses the impact of e-commerce expansion on reducing emissions, providing new idea for digital carbon emissions reduction and offers policy implications for sustainable economic development in many developing countries (regions).

Exploring the experience of participants in a pilot scheme to recognise teaching excellence in healthcare: A mixed methods approach.

BackgroundWithin healthcare settings, practice-based healthcare professionals are expected to teach, supervise, assess and/or support learners in their respective disciplines. Ongoing development opportunities focusing specifically on teaching skills and support of students are varied and there are no mandatory requirements for practice-based healthcare professionals to develop formal teaching qualifications, despite their direct involvement with learners. ObjectiveTo explore the experience of participants in a pilot scheme to recognise teaching excellence in healthcare. DesignA mixed methods approach was used. Setting(s)One inner-city integrated health care system in the UK. ParticipantsThis study involved eleven participants in total: seven applicants who successfully completed the award and four mentors who supported them throughout the application process. Mentors were all Advance HE Fellowship holders employed within one National Health Service (NHS) organisation and one Higher Education Institution situated within the Northwest of England. MethodsData collection methods included an online anonymised survey followed by individual semi- structured interviews. Quantitative data were analysed descriptively, and qualitative data were analysed using framework analysis principles. ResultsThe findings indicated that participants (applicants and mentors) found the overall experience positive and rewarding. The main positive aspects of taking part were:I. Increased confidence and sharing of teaching experienceII. Increased reflection and use of pedagogyIII. Formation of a teaching community of practiceIV. Perceived teaching career progression opportunitiesThe application process appeared to act as a catalyst towards re-engagement with underpinning pedagogy when considering the suitability and utility of effective teaching approaches for learners in practice. It also helped to promote a teaching community of practice where mentors were able to ‘pay forward’ and support practice colleagues to be recognised for their teaching roles.The main challenges were the competing demands on applicants’ time and the self-directed approach required to complete the award application. ConclusionGaining recognition of teaching excellence through an award scheme such as Advance HE Fellowship can foster a sense of empowerment, recognition and reward for educators who work with learners undertaking Higher Education Programmes, irrespective of the setting where teaching and learning takes place. However, without wider organisation support and resources, the benefits of such schemes can be diminished. RegistrationN/A Tweetable abstractWith institutional support, Advance HE Fellowships offer accessible recognition for healthcare educator's commitment to teaching excellence @AdvanceHE @NHSE_WTE

AI-driven health data analytics for early detection of infectious diseases: A conceptual exploration of U.S. public health strategies

This review paper explores the role of AI-driven health data analytics in enhancing the early detection and response to infectious diseases within U.S. public health strategies. It begins by outlining the importance of timely detection in controlling outbreaks and discusses current public health systems and their limitations, including passive surveillance and data fragmentation. The paper highlights innovative AI technologies such as machine learning, natural language processing, and predictive modeling, which can significantly improve disease monitoring and forecasting. By analyzing vast datasets in real time, these technologies facilitate quicker identification of emerging health threats and enable tailored public health responses. Furthermore, the review presents recommendations for integrating AI innovations into existing public health strategies, emphasizing improved data interoperability, investment in infrastructure, stakeholder collaboration, community engagement, and real-world pilot programs. Ultimately, the findings underscore the potential of AI-driven health data analytics to transform infectious disease management, thereby safeguarding public health.

The Past, Present and Future of Voter ID in Great Britain—Voter Turnout, Rejection and Confidence

AbstractThis article examines the implementation of voter identification at polling stations for elections in Great Britain, in particular following the passage of the Elections Act 2022. For this purpose it groups the affected and most significant elections into four chronological studies. These are, first, the initial pilot schemes conducted in 2018 and 2019, second, the May 2023 local elections in England, third, the 10 parliamentary by-elections held in Great Britain between July 2023 and May 2024, and fourth, the July 2024 UK General Election which marked by far the biggest test of the new requirements. The article examines the historical context and key statutory provisions which introduced voter ID, before analysing the respective studies relying on official Electoral Commission and UK Parliament data, as well as data gathered by volunteer organisations and the author’s own observations at polling stations. For this purpose, the case studies focus on the issues of voter turnout, rejection and confidence, as these are easily quantifiable measures which can assist with the legal analysis. As such, the article assesses the legality of voter identification laws in the UK, in particular from a human rights perspective, arguing that the implementation of voter ID has been problematic from the outset. Data produced after the elections raises further questions over the necessity and proportionality of the measures, suggesting that further reforms are needed if the policy is to remain in place.

Multidisciplinary Collaboration and Industry Partnership: Keys for the Development of the Masters of Geomatics in Disaster Risk Reduction Curriculum

Abstract. Despite the high susceptibility of the Philippines to natural disasters, there is a significant lack of human resources focused on disaster risk reduction (DRR). To address this, the University of the Cordilleras, in collaboration with the ERASMUS CBHE Plus Program: Geomatics in Disaster Risk Reduction of the European Union, has developed a curriculum for a GeoDRR program. This program is designed to produce professionals with expertise in disaster risk reduction, geomatics, and remote sensing. The curriculum development employed a mixed-methods approach using the ADDIE (Analyze, Design, Develop, Implement, Evaluate) Framework and the DACUM (Developing a Curriculum) method. The ADDIE Framework guided the structured development process, while the DACUM method identified the necessary competencies for students. The resulting UC MGeoDRR curriculum comprises 15 units of Core Courses, 15 units of Professional Courses, 9 units of Electives, and a 6-unit Capstone project. The curriculum is designed to be localized and contextually relevant, integrating DRR into research, innovation, and extension activities. The pilot program is recommended for graduates of related undergraduate programs and DRR professionals and practitioners.

Appropriately matching transport care units to patients in an interhospital Transport Care: an implementation report.

In interfacility transport care, a critical challenge exists in accurately matching ambulance response levels to patients' needs, often hindered by limited access to essential patient data at the time of transport requests. Existing systems cannot integrate patient data from sending hospitals' electronic health records (EHR) into the transfer request process, primarily due to privacy concerns, interoperability challenges, and the sensitive nature of EHR data. We introduce a distributed digital health platform, Interfacility Transport Care (ITC)-InfoChain, designed to solve this problem without compromising EHR security or data privacy. This report details the implementation of Interfacility Transport Care (ITC)-InfoChain, a secure, blockchain-based platform designed to enhance real-time data sharing without compromising data privacy or EHR security. The ITC-InfoChain platform prototype was implemented on AWS cloud infrastructure, employing Hyperledger Fabric as a permissioned blockchain. Key elements included participant registration, identity management, and patient data collection isolated from the sending hospital's EHR system. The client program submits encrypted patient data to a distributed ledger, accessible to the receiving facility's critical care unit at the time of transport request and EMS teams during transport through the PatienTrack web application. Performance was evaluated through KPIs such as data transaction times and scalability across transaction loads. The ITC-InfoChain demonstrated strong performance and scalability. Data transaction times averaged 3.1 seconds for smaller volumes (1-20 transactions) and 6.4 seconds for 100 transactions. Optimized configurations improved processing times to 1.8-1.9 seconds for 400 transactions. These results confirm the platform's capacity to handle high transaction volumes, supporting timely, real-time data access for decision-making during transport requests and patient transfers. The ITC-InfoChain platform addresses the challenge of matching appropriate transport units to patient needs by ensuring data privacy, integrity, and real-time data sharing, enhancing coordination of patient care. The platform's success suggests potential for regional pilots and broader adoption in secure healthcare systems. Stakeholder resistance due to blockchain unfamiliarity and data privacy concerns remains. Funding has been sought to support a pilot program to address these challenges through targeted education and engagement.

DISP-09. IMPROVING ADHERENCE TO CANCER CARE IN UNDERSERVED PATIENTS WITH CENTRAL NERVOUS SYSTEM TUMORS

Abstract Patients with central nervous system tumors have disease-specific symptoms such as aphasias, motor symptoms, neuropsychiatric symptoms, or seizures that make treatment adherence difficult. This is further exacerbated by the social determinants of health – patients from historically marginalized groups or those with lower socioeconomic status have additional barriers to treatment. The Integrated Cancer Care Access Network (ICCAN) is a multi-institutional patient navigation program assisting patients who express socioeconomic needs during cancer treatment. In this pilot program, we assessed the impact of ICCAN on treatment adherence and quality of life of CNS cancer patients from marginalized backgrounds. 42 participants with primary brain tumors or brain metastases were recruited from inpatient and outpatient services at Memorial Sloan Kettering Cancer Center to enroll in ICCAN-CNS. Patients were eligible if they were 18 years or older, receiving active treatment or under active surveillance, and screened positive for an essential need. Through standardized patient interviews and questionnaires, we evaluated their needs such as food access, housing, and financial needs. The clinical research coordinator interviewed the patients via phone, taking approximately 60 minutes. The interviews comprised an Essential Needs Assessment, Health Related Social Needs Assessment, NCCN Distress Thermometer, and an ICCAN-CNS questionnaire focused on neurology-specific symptoms. Caregivers helped complete the questions for patients with cognitive impairments. Patients were then matched with resources based on their initial needs assessment. The interviewer conducted 2, 4, and 6-month follow-ups to see if new needs emerged for which resources were provided. Response to the program was overwhelmingly positive with many patients expressing gratitude for the resources provided to them. This pilot demonstrates the feasibility of CNS tumor patients participating in the ICCAN intervention and the need for additional patient navigation programs and interventions that focus on the social determinants of health.

The impact of vertical and horizontal pressures on policy diffusion: evidence from APLS adoption in China

This study examines the diffusion of governmental self-regulation policy, specifically the Administrative Power List System (APLS) in China, which has received less focus than economic or social policies within horizontal and vertical pressure frameworks. By employing event history analysis and case studies, the research compares local government adoption behavior before and after the central intervention. The findings reveal that, in the absence of strong central directives, local governments are often reluctant to replicate neighboring policies, as they strive for distinctiveness in their innovations. However, once the central government issues mandates, local governments quickly adapt and implement practices observed elsewhere. The study also highlights significant vertical influences from provincial and county governments. During the exploration stage, top-down pressure from provincial governments enhances municipal adoption, although this influence is eventually surpassed by central mandates. Bottom-up learning from county-level pilot programs significantly improves adoption efficiency, especially when local governments face pressure for rapid implementation. This study contributes to the policy diffusion literature by analyzing the diffusion of governmental self-regulation policy and highlighting the mixed impacts of horizontal and vertical pressures on policy learning and adoption, with central intervention playing a crucial role.

UNC Charlotte Autonomous Shuttle Pilot Study: An Assessment of Operational Performance, Reliability, and Challenges

This paper presents the findings from an autonomous shuttle pilot program conducted at the University of North Carolina at Charlotte between June and December 2023 as part of the North Carolina Department of Transportation’s Connected Autonomous Shuttle Supporting Innovation (CASSI) initiative. The shuttle completed 825 trips, transporting 565 passengers along a 2.2-mile mixed-traffic campus route. The study evaluates the shuttle’s operational performance, reliability, and challenges using data from onboard sensors, system logs, and operator reports. Key analyses are divided into four areas: service reliability, which assesses autonomy disengagements caused by signal loss, technical issues, and environmental factors; service robustness, focusing on the shuttle’s ability to maintain operations under adverse conditions; performance metrics, including average speed, autonomy percentage, and battery usage; and service usage, which examines the number of trips and passengers to gauge efficiency. Signal loss and battery-related issues were the primary causes of service interruptions, while environmental factors like weather and vegetation also affected shuttle performance. Recommendations include enhancing vehicle-to-infrastructure communication and optimizing battery management.

AI MyData: Fostering Middle School Students’ Engagement with Machine Learning through an Ethics-Infused AI Curriculum

As initiatives on artificial intelligence (AI) education in K-12 learning contexts continues to evolve, researchers have developed curricula among other resources to promote AI across grade levels. Yet, there is a need for more effort regarding curriculum, tools, and pedagogy, as well as assessment techniques to popularize AI at the middle school level. Drawing on prior work, we created original curriculum activities with innovative use of existing technology, a new computational teaching tool, and a series of approaches and assessments to evaluate students’ engagement with the learning resources. Our curriculum called AI MyData comprises elements of ML and data science infused with ethical orientation. In this paper, we describe the novel AI curriculum and further discuss how we engaged students in learning and critiquing AI ethical dilemmas. We gathered data from two pilot studies conducted in the Northeast United States, one Artificial Intelligence Afterschool (AIA) program, and one virtual AI summer camp. The AIA program was carried out in a local public school with four middle school students aged 12 to 13; the program consisted of eleven two-hour sessions. The summer camp consisted of two-hour sessions over four consecutive days, with eighteen students aged 12 to 15. We facilitated both pilot programs with hands-on plugged and unplugged activities. The method of capturing data included artifact collection, structured interviews, written assessments, and a pre- to post-questionnaire tapping participants’ dispositions about AI and its societal implication. Participant artifacts, written assessments, survey, observation, and analysis of tasks completed revealed that the children improved in their knowledge of AI. In addition, the AI curriculum units and accompanying approaches developed for this study successfully engaged the participants, even without prior knowledge of related concepts. We also found an indication that introducing ethics of AI to adolescents will help their development as ethically responsive citizens. Our study results also indicate that lessons establishing links with students’ personal lives (e.g., letting students choose personally meaningful datasets) and societal implications using unplugged activities and interactive tools were particularly valuable for promoting AI and the integration of AI in middle school education across the subject domains and settings. Based on these results, we discuss our findings, identify their limitations, and propose future work.

The barriers and enablers to completing the RPS core advanced pharmacist credentialing programme via the CPPE/RPS pilot programme

Abstract Introduction The RPS and CPPE launched a pilot programme in March 2023 to support 300 pharmacists to evidence their advanced practice via an e-portfolio aligned to the RPS Core Advanced curriculum1 in a 12-week period. Successful pharmacists are credentialed as Advanced Pharmacists. The pilot involved CPPE education supervisors (ESs) support, an online learning platform and small group learning and support. Aim To ascertain barriers and enablers to completing an advanced e-portfolio and to identify how to improve the on-going programme. Methods The invitation to complete the anonymous survey in May 2024 was administered via www.onlinesurveys.ac.uk and developed linking to key performance indicators around education supervision support, to understand why candidates were deferring cohorts and to ascertain additional support accessed by candidates. Ethical approval was not required as study is service evaluation. Candidates who responded included those who successfully submitted their e-portfolio ‘submitted candidates’ n=10, candidates who are resubmitting their portfolio after not passing ‘resubmission candidates’ n=8, pharmacists currently completing their portfolio ‘current candidates’ n=44 and those who started but left without submitting ‘attrition candidates’ n=13. Results All submitted candidates scored ES support as very good/excellent; 60% agreed strongly they would not have submitted their portfolio without this support. Each cohort had two small-group tutorials where candidates accessed peer support and joined WhatsApp groups. Only 38% of resubmission candidates, compared to 80% of portfolio submitted candidates attended both group tutorials. Resubmission candidates were less likely to access additional peer support (38% for resubmission candidates vs 60% for submitted candidates) or to join the cohort WhatsApp group (75% for resubmission candidates vs 90% for submitted candidates). Resubmission candidates rated the remedial SMART action planning support highly. Submitted candidates would have found it easier to complete their portfolio with more comprehensive (60%) and timely responses (70%) from their collaborators. This compares to 55% and 59% of current candidates recognising the same issues. Submitted candidates wanted more allocated time during working hours to support completion of the portfolio (60% rising to 80% for current candidates). There is a notable increase for current candidates wanting a longer period to complete their portfolio (75% compared to 40% of submitted candidates). Half of submitted candidates (50%) reported spending more than 5 hours (average) each week on their portfolio compared to 18% of current candidates. Top reasons for attrition include too busy with work, family responsibilities, personal health challenges and no support from the workplace. Candidates across all groups suggested programme improvement ideas including more evidence examples, making the RPS platform less difficult to navigate and use, and more education supervisor support. Motivating factors for completion include recognition of advanced level working and preparation for the consultant portfolio. Conclusion Enablers include education supervision, CPPE resources/facilitated support events, peer support, WhatsApp groups, recognition and career progression. Key barriers include needing more time and lack of dedicated time at work to complete e-portfolio, lack of timely and comprehensive support from collaborators and finding the RPS e-portfolio platform difficult to navigate. Limitations – low numbers and response rate. Data collection is on-going. Reference 1. Royal Pharmaceutical Society, Core Advanced Pharmacist Curriculum, 2022 https://www.rpharms.com/Portals/0/Credentialing/RPS%20-%20Core%20Advanced%20curriculumFINAL.pdf?ver=8gc3s2aE9t1nZN37CSU7Lw%3d%3d (Accessed 28 May 2024)

Cervical precancer screening using self-sampling, HPV DNA testing, and mobile colposcopy in a hard-to-reach community in Ghana: a pilot study

BackgroundThe World Health Organization has set ambitious goals to eliminate cervical cancer, necessitating evidence on increasing coverage and access to screening and treatment in high-burden areas. We implemented a pilot program to assess the feasibility of obtaining self-collected specimens for high-risk human papillomavirus (hr-HPV) testing in Nzulezo stilt village, a hard-to-reach community in Ghana, and inviting only hr-HPV-positive women to a central location for colposcopy and possible treatment. Subsequently, this study aimed to investigate the prevalence of hr-HPV infection and cervical lesions among the women and to explore factors potentially associated with hr-HPV infection among them.MethodsThis pilot community-based cross-sectional study utilized data from screening sessions held from 2 to 20 November 2021 with specimens collected by participants using Evalyn brushes. HPV DNA testing was performed using the Sansure MA-6000 platform, while visual inspection utilized the Enhanced Visual Assessment (EVA) mobile colposcope. Univariate and multivariable nominal logistic regression was employed to explore factors associated with hr-HPV positivity.ResultsAmong 100 women screened (mean age, 43.6 ± 14.5 years), the overall hr-HPV prevalence rate was 39.0% (95% CI, 29.4–49.3). The prevalence rates of hr-HPV genotypes were stratified as follows: HPV16–8.0% (95% CI, 3.5–15.2), HPV18–5.0% (95% CI, 1.6–11.2), and other genotype(s) – 31.0% (95% CI, 22.1–41.0). Single-genotype infections with HPV16 and HPV18 were found in 4.0% (95% CI, 1.1–9.9) and 3.0% (95% CI, 0.6–8.5) of women, respectively. Mixed infections were observed in 1.0% (95% CI, 0.0–5.4) for HPV16 + 18, 3.0% (95% CI, 0.6–8.5) for HPV16 + other type(s), and 1.0% (95% CI, 0.0–5.4) for HPV18 + other type(s). The prevalence of cervical lesions among hr-HPV-positive women screened via colposcopy was 11.4% (95% CI, 3.2–26.7). In the multivariable model, reliance on other sources for medical bill payment was associated with hr-HPV infection (aOR, 0.20; 95% CI, 0.04–0.93), whereas age was not (aOR, 1.02; 95% CI, 0.99–1.05).ConclusionsA high hr-HPV infection prevalence was recorded among the women. Utilizing technologies such as self-sampling, HPV DNA testing, and mobile colposcopy enables screening and treatment in remote and hard-to-reach communities where access to cervical cancer screening and treatment would otherwise be limited. Further research is warranted to assess the value and scalability of this approach in similar remote areas and its potential implementation in future programs.

Assessment of the Impact of China's Carbon Emissions Trading Pilot Policy on the Export Product Quality

To achieve the "dual carbon" goals, China has established a carbon emissions trading market to reduce corporate carbon emissions through market mechanisms. The effect of China's carbon trading pilot programme on export product quality is examined in this study. The analysis employs the quasi-natural experiment provided by this policy, focusing on the quality of exported goods. From 2009 to 2016, panel data from 31 provinces and municipalities created a difference-in-differences (DID) model. This model allows for a comprehensive examination of the impact at the city, industry, and destination country levels. The results show that the quality of exported goods is much improved by the adoption of the carbon trading pilot programme. Additionally, the examination of heterogeneity shows that the influence of the policy is greatest in central cities, with less noticeable effects in the eastern and western areas. The report offers suggestions for advancing carbon trading policies at its conclusion, including the adoption of customized strategies that take into account the distinctive qualities of certain geographic areas. These recommendations are intended to maximise the effectiveness of the carbon trading system and support China's broader environmental and economic objectives.

The International and Local Politics of the Rural Environmental Registry: Brazil's Green Currency

ABSTRACTSince the 2000s, rural elites have engaged in ‘greening’ the Amazon extractive frontier. Private and state‐led initiatives have consolidated the agro‐industrial system by incentivizing compliance and effectively legalizing deforestation. Brazil's Rural Environmental Registry (Cadastro Ambiental Rural — CAR) is fundamental to ‘sustainable producer’ initiatives and international and local carbon markets. Since its emergence at the end of the 1990s, it has been funded and promoted by European countries and the World Bank through the G7 Pilot Programme for the Conservation of Brazilian Rainforests and the Amazon Fund. This analysis draws on a critical political economy approach and several years of multi‐site interviews, participant observation and archival research to illuminate how donor and recipient agencies have sustained territorial and georeferencing technologies as an international state project to enable the green economy, despite political shifts and the inherent contradictions of this instrument. The article shows how ecological modernization technologies enable the ‘greening’ of agro‐industry expansion while exacerbating land conflicts and marginalizing Indigenous and traditional peoples’ collective land rights.

Growth and Performance of Self Help Group’s - An Exploratory Study

Today there are Mainstream Micro Finance Institutions like National Agricultural Bank for Rural Development (NABARD), Small Industries Development Bank of India (SIDBI) etc., which are creating micro credit, in rural areas by extending micro finance to Self Help Group (SHG’s) with the help of formal credit institutions, making it an effective poverty reducing strategy and simultaneously promoting rural development. SHG’s were initiated to empower the economically disadvantaged people, who were neglected by formal credit and savings institutions. Micro finance has shown that poor people, when given access to timely and responsive financial assistance, use the proceeds to not only increase their assets and income, but also repay their debts. NABARD, through its Micro Credit Innovations, is the facilitator and mentor of microfinance initiatives in the country. The model of Self help group- bank linage programme (SBLP) has evolved as a cost-effective mechanism for providing financial services to the unreached and deserving poor households. The initiative started as a pilot to link around 500 SHGs of poor to the formal financial institutions during the year 1992-93.The success of the pilot program has shown that Micro Finance can go beyond poverty reduction, to addresses issues of health, education, gender and over all development The present paper is a comparative study of the agency wise i.e. commercial banks, regional rural banks, and cooperative banks, performance in the SHG’s - bank linkage program in Telangana, from2014-18,. The paper also presents an in-depth, analysis of the number of self-help groups, Amount of savings outstanding, amount of loan outstanding of the SHGs, , and total loans disbursed to them through SBLP, generating micro credit to reduce poverty and boost rural development. Key words: NABARD, Micro Finance, SHG’s, SBLP, poverty reduction, rural Development,

Comorbid treatment of traumatic brain injury and mental health disorders.

The Emory Healthcare Veterans Program (EHVP) is a multidisciplinary intensive outpatient treatment program for post-9/11 veterans and service members with invisible wounds, including posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), substance use disorders (SUD), and other anxiety- and depression-related disorders. This article reviews the EHVP. The different treatment tracks that provide integrated and comprehensive treatment are highlighted along with a review of the standard, adjunctive, and auxiliary services that complement individualized treatment plans. This review particularly emphasizes the adjunctive neurorehabilitation service offered to veterans and service members with a TBI history and the EVHP data that indicate large reductions in PTSD and depression symptoms across treatment tracks that are maintained across 12 months follow up. Finally, there is a discussion of possible suboptimal treatment response and the pilot programs related to different treatment augmentation strategies being deploying to ensure optimal treatment response for all. Published data indicate that the two-week intensive outpatient program is an effective treatment program for a variety of complex presentations of PTSD, TBI, SUD, and other anxiety- and depression-related disorders in veterans and active duty service members.

Improving sustainability in sexual health: A pilot project reintroducing reusable stainless steel vaginal specula at a sexual health clinic.

In line with the NHS net zero initiative, University Hospitals Sussex (UHS) committed to a Green Plan which included the introduction of reusable instruments. Following positive responses from a staff and patient survey in 2021, the sexual health and contraception (SHAC) department began a pilot scheme of 100 medium size reusable stainless steel vaginal specula (RMS) as an alternative to disposable acrylic models. The aim was to determine outcomes regarding sustainability goals and clinician experiences. Estimated carbon footprint and cost was calculated for actual use during study period, and expected use if RMS were to be exclusively used in the future. A staff questionnaire was distributed to ascertain attitudes towards RMS, including obstacles to their use and how these might be overcome. Monthly medium size plastic specula use decreased during the pilot, resulting in a 22.4% reduction in carbon footprint. Exclusively using RMS for all examinations could reduce carbon emissions by 85.6%. Clinicians had an overall positive attitude towards RMS. Key obstacles to use were poorly stocked rooms and insufficient variety of size. The success of this pilot scheme is being built upon by investing in a greater variety of sizes of RMS for use in SHAC aiming for a 100% reusable system.

Evaluation of a longitudinal Indigenous health elective in family medicine

Background: In response to the Truth and Reconciliation Commission of Canada Calls to Action 22 to 24 around health, the Department of Family Medicine at the University of Calgary piloted a novel Indigenous Health Longitudinal Elective (IHLE) to give first year residents longitudinal experiences in Indigenous healthcare environments. The purpose of this evaluation was to capture the successful qualities and identify areas for improvements to ensure feasibility of the IHLE pilot program. Methods: Between November 2022 and April 2023, semi-structured interviews were completed with seven participants of the IHLE and included a mix of residents, preceptors, and clinic staff members. Qualitative thematic analysis was used to gain an in-depth understanding of the IHLE program experiences of all participants. Results: Benefits of the IHLE program include a deeper understanding of the values and priorities critical to working in healthcare with Indigenous peoples in Southern Alberta. Areas for improvement include clarity around IHLE program structure; clearly defining roles and responsibilities for preceptors; increased opportunities for reciprocity and relationality; and a deeper self-reflection process. Conclusion: Recommendations for future iterations of the IHLE include ensuring preceptors are trained and engaged, while providing residents more opportunities for relationality and peer debriefing. Results from this study may also help inform future Indigenous health programming in family medicine.

Pharmacogenomics concierge service as an opportunity for pharmacist reimbursement and practice-based learning

ObjectiveTo assess the feasibility of a pilot pharmacogenomics concierge service that incorporates student practice-based learning opportunities and a survey to determine patients’ interest and willingness to pay. MethodsParticipants in the pilot study (n=34) completed a survey to determine their willingness to pay for concierge services. Six participants indicating the highest level of interest were selected to participate in the program free of charge. Students conducted preliminary genetic testing to assess the potential value of a pharmacogenomics service. For the subset of participants (n=6) invited to the concierge service, confirmatory genetic testing was completed by a third-party lab. A layered learning model allowed senior students to mentor and train junior students in the area of pharmacogenomics. ResultsSix invited participants completed the concierge program and third party pharmacogenomic testing, and the majority (83%) received pharmacogenomic consultation with the pharmacist. Completed surveys from participants in the pilot program (n=34) indicated a willingness to pay $25-50 a month to have continued access to a pharmacist. Surveyed individuals rated their likelihood of utilizing the concierge service at a mean rating of 8.6 (SD=1.88) on a scale of 1 to 10 although this rating dropped significantly if insurance did not cover the cost. The pilot program offered opportunities for practice-based learning through a layered learning model. ConclusionThis pilot concierge program presented several successes and challenges which may help others avoid common pitfalls and spur discussion on optimal ways to develop new pharmacy services and experiential opportunities for students.

Social credit scoring system and corporate pollution governance: Insights from China's Social Credit System Construction

This study examines the effect of China's Social Credit System (CSCS) construction as a quasi-natural experiment on corporate emissions. The System collects and shares credit information, including environmental credit for firms. Using 30,766 firm-year observations of Chinese non-financial listed firms from 2007 to 2021 and pilot programs in the construction of the CSCS in various cities, we document that firms located in cities with the CSCS system lower their emissions than those in cities without the CSCS system. Additional analysis suggests that the lower emission for the CSCS firms is due to enhancing environmental information disclosure, advancing technological progress, and alleviating financial constraints. The moderating analysis reveals that the impact of the CSCS on restraining corporate emissions is more salient when a firm: (1) belongs to a heavily polluting industry or is privately-owned; (2) has management myopia or lack of environmental awareness; or (3) has a weak internal and external monitoring.