Policy Development Research Articles

Treatment engagement in comorbid alcohol use disorder and alcohol-related liver disease: A qualitative exploration of barriers and facilitators with service users.

Effective interventions to improve patient outcomes in comorbid alcohol use disorder (AUD) and alcohol-related liver disease (ARLD) remain a clinical unmet need. While the choice of abstinence is the cornerstone for the prevention of disease progression and mortality, evidence suggests a suboptimal engagement with treatment supporting recovery. This qualitative investigation aims to understand barriers and facilitators to treatment as experienced by this clinical population by applying a multidimensional adherence model proposed by the World Health Organization. Twenty-four participants with comorbid AUD and ARLD were recruited from an inpatient clinical setting. Data for this study were collected through semistructured, in-depth interviews. Deductive analysis was organized by the Framework method, and theory-driven themes were identified according to the multidimensional adherence model. This included factors across the social and economic, patient, condition, treatment, and healthcare system levels. The findings in this study indicate systematic challenges in maintaining continuity between primary, secondary, and community care. Aspects related to social and economic context, treatment, and healthcare systems were found to hinder engagement. Identified facilitators to engagement included the participatory role of family, shared lived experience of addiction/recovery, and therapeutic alliance with healthcare providers. The understanding of these barriers and facilitators from a service user's perspective can bridge the treatment gap for this clinical population. This can provide an opportunity for the implementation of effective interventions and inform the development of policies promoting accessible care. Government and public health bodies have fundamental roles in shifting treatment paradigms in comorbid AUDand ARLD.

Decarbonizing the US Energy System

Recent rapid and unexpected cost reductions in decarbonization technologies have accelerated the cost-effective decarbonization of the US economy, with greenhouse gas (GHG) emissions falling by 20% from 2005 to 2020. The literature on US economy-wide decarbonization focuses on maximizing long-term GHG emissions reduction strategies that rely mostly on renewable energy expansion, electrification, and efficiency improvements to achieve net-zero GHG emissions by 2050. While these studies provide a valuable foundation, further research is needed to properly support decarbonization policy development and implementation. In this review, we identify key decarbonization analysis gaps and opportunities, including issues related to cross-sectoral linkages, spatial and temporal granularity, consumer behavior, emerging technologies, equity and environmental justice, and political economy. We conclude by discussing the implications of these analysis gaps for US decarbonization pathways and how they relate to challenges facing major global emitters.

Strategic insights for sustainable growth of mushroom farming industry in Bangladesh: A comprehensive evaluation using SWOT-AHP and TOPSIS frameworks

Mushroom farming using agri-waste as substrates can offer a sustainable solution to the food security challenges of inadequate and imbalanced diets. Developing strategies to exploit the potential of the mushroom industry fully is yet to be explored in Bangladesh. We, thus, conducted this study to investigate the challenges and opportunities associated with mushroom farming, as well as the characteristics of farms and employees engaged in this industry. A directional stepwise multiple regression analysis showed self-motivation, spawn cost, farm size, and training are the key influencing factors driving profitability. Farm surveys identified SWOT factors with 24 sub-factors cross-validated with expert consultations. The sub-factors were categorized as beneficial (strength and opportunities) and cost (weakness and threats) to formulate the SWOT strategies using the Grey-TOPSIS method. Results indicate a favorable scenario exists for the industry in Bangladesh, with significant opportunities (group weight 0.53) and minimal threats (group weight 0.09). We proposed 12 strategic alternatives for the sustainable growth of this industry. This top-ranking strategy is not only to secure funding (relative closeness, C+ = 0.87) but also to provide more accessible loan options envisioning a strategic expansion of business operations in Bangladesh. The evaluation highlighted the significance of collaboration with other mushroom farmers to maximize the gain in marketing that will substantially expand the local demand (C+ = 0.697). Besides, product diversification is also underscored as an important strategy for the growth of the industry. These prioritized SWOT strategies lay the groundwork for policy development, aiding decision-makers in steering the mushroom industry towards sustainable growth for developing countries like Bangladesh. Promoting such an eco-friendly industry will generate ample opportunities for women's employment and appreciable profit while contributing to environmental improvement through recycling agri-waste.

Impact of Data Governance on Data Quality in Healthcare Institutions

Purpose: The aim of the study was to assess the impact of data governance on data quality in healthcare institutions. Materials and Methods: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: The study found that institutions with robust data governance protocols experience fewer instances of data inconsistency and errors. This, in turn, improves the reliability of clinical decision-making processes and patient outcomes. Moreover, compliant data governance practices contribute to better data integration across various healthcare systems and departments, facilitating comprehensive patient care and longitudinal health monitoring. By promoting transparency and accountability in data management, healthcare institutions can mitigate risks associated with data breaches and ensure compliance with regulatory standards, thereby fostering trust among patients and stakeholders alike. Implications to Theory, Practice and Policy: Control theory, information theory and agency theory may be used to anchor future studies on assessing the impact of data governance on data quality in healthcare institutions. Healthcare institutions should prioritize the adoption of comprehensive data governance frameworks that integrate policy development, stakeholder engagement, and technological infrastructure. Policymakers should align regulatory frameworks with evolving data governance standards to promote interoperability and data exchange across healthcare networks.

Assessment and Prediction of Health and Agricultural Impact from Combined PM2.5 and O3 Pollution in China

Combined PM2.5 and O3 pollution in China has caused negative health impacts on residents and reduced crop yields. The quantitative assessment and prediction of these impacts could provide a scientific basis for policy development. This study assessed the nationwide premature mortality, health effects, and crop damage attributable to PM2.5 and O3 pollution in 2019, and projected the associated health and agricultural losses under a business-as-usual (BAU) scenario for 2025. The economic benefits of improving air quality under different policy scenarios, including the 14th Five-Year Plan (FFP), Secondary Standard Limit (SSL), and Primary Standard Limit (PSL), were also explored. The results showed PM2.5 pollution in 2019 resulted in 246,000 all-cause premature deaths and the economic health loss was RMB 196.509 billion. Similarly, O3 pollution caused 186,300 premature deaths and the economic health loss was RMB 155.807 billion. O3 pollution has led to a loss of 28.5241 million tonnes of crop production and an economic loss of RMB 62.268 billion. Compared with 2019, the avoidable premature deaths from PM2.5 under different scenarios in 2025 were 50,600, 43,000, and 200,300 cases, respectively, exceeding the number of avoided premature deaths from O3 pollution. Compared with the BAU, reducing PM2.5 under different scenarios could generate economic benefits of RMB 70.178 billion, RMB 60.916 billion, and RMB 229.268 billion. Furthermore, the FFP scenario outperformed the SSL in mitigating winter wheat production losses caused by O3 pollution. These results provide important scientific support for the development and evaluation of future comprehensive pollution control measures for PM2.5 and O3.

Influence of citizen relationship management system on citizen participation in Taiwan: A participatory politics perspective

Although studies have investigated the development of citizen relationship management (CRM) systems in various cities, no understanding exists regarding how CRM systems operate and how they influence citizen participation. Moreover, limited studies have been conducted regarding the political factors that influence citizen participation through CRM systems. Drawing from data obtained through interviews with key stakeholders involved in the implementation of a CRM system in Taiwan, the present study comprehensively analyzed the primary political characteristics and effects of this system, outlined the political factors influencing system use, and formulated suggestions for mitigating the influence of politics on the system. The findings reveal that the development of the citizen relationship management system was constrained by potential political factors in public policy development. These factors included the dynamics of power relations between citizens and local governments, the politicization of policy processes, conflicts in policy decision-making models involving top-down and bottom-up approaches, the political intentions and motives of stakeholders, and the influence of potential policy actors. Considering the case of the Taiwanese citizen relationship management system, this study provides suggestions and guidance for policymakers aiming to minimize political influence on citizen participation, with a focus on tailoring these approaches to meet the specific public service needs of citizens.

The blue economy effects on EUROMED tourism: forecasting approach

This study examines the factors that influence the blue economy in EUROMED, aiming at promoting economic growth in line with the UN Sustainable Development Goals. EUROMED was chosen because all of its nations have fisheries and marine tourism, which are the two key indicators of the blue economy. Blue economy contributes to sustainable development in the fisheries and marine tourism sectors. A commitment to sustainability has sped up national and regional blue economy policy development. The study uses secondary qualitative data and literature review to analyse the synergies and conflicts between EUROMED blue economy strategies and the UN Sustainable Development Goals. The findings suggest that GDP growth, aqua production, open trade, CO2 emissions, and inflation rate influence the blue economy, and that ecotourism that considers education, society, and the environment may generate sustainable fisheries and marine tourism. Only 21 countries gave the ARDL test between 2000 and 2019. This study analyses synergies and conflicts between EUROMED blue economy strategies and UN Sustainable Development Goals. Location-based contextual development of blue economies that suit all players' requirements is essential to maintain sustainability objectives. Ensure resilience against future environmental and political shocks, preserve the ecological underpinning for vibrant blue economies, and create capacity at all levels to promote effective and fair governance. This study tries to make good use of ocean conservation and aquaculture within the context of the blue economy. This is the first EUROMED blue economy study and contributes to the theoretical and methodological development of blue economy research.

Artificial intelligence and sustainable development during urbanization: Perspectives on AI R&D innovation, AI infrastructure, and AI market advantage

AbstractThis study explores the impact of artificial intelligence (AI) on sustainable development across 51 countries during urbanization. Using panel data, the study examines AI's effects on sustainable development through three dimensions: R&D innovation, infrastructure, and market advantage. The results demonstrate that AI promotes sustainable development, with AI R&D innovation exerting the strongest influence, followed by AI infrastructure, whereas AI market advantage has the smallest impact. Additionally, the study uncovers regional heterogeneity in AI's impacts. In countries with upper middle sustainable development levels (60%–70% quantiles), AI's promoting effect is the strongest. Moreover, urbanization plays a threshold role in the relationship between AI and sustainable development. When urbanization is below the threshold, AI infrastructure and R&D innovation promote sustainable development, whereas AI market advantage inhibit it. Conversely, when urbanization exceeds this threshold, AI infrastructure inhibits sustainable development, the impact of AI R&D innovation becomes insignificant, and AI market advantage begin to promote sustainable development. This study recommends governments should consider the level of urbanization and sustainable development when crafting sustainable development policies utilizing AI.

Efficiency and Driving Factors of Agricultural Carbon Emissions: A Study in Chinese State Farms

Promoting low-carbon agriculture is vital for climate action and food security. State farms serve as crucial agricultural production bases in China and are essential in reducing China’s carbon emissions and boosting emission efficiency. This study calculates the carbon emissions of state farms across 29 Chinese provinces using the IPCC method from 2010 to 2022. It also evaluates emission efficiency with the Super-Slack-Based Measure (Super-SBM model) and analyzes influencing factors using the Logarithmic Mean Divisia Index (LMDI) method. The findings suggest that the three largest carbon sources are rice planting, chemical fertilizers, and land tillage. Secondly, agricultural carbon emissions in state farms initially surge, stabilize with fluctuations, and ultimately decline, with higher emissions observed in northern and eastern China. Thirdly, the rise of agricultural carbon emission efficiency is driven primarily by technological progress. Lastly, economic development and industry structure promote agricultural carbon emissions, while production efficiency and labor scale reduce them. To reduce carbon emissions from state farms in China and improve agricultural carbon emission efficiency, the following measures can be taken: (1) Improve agricultural production efficiency and reduce carbon emissions in all links; (2) Optimize the agricultural industrial structure and promote the coordinated development of agriculture; (3) Reduce the agricultural labor scale and promote the specialization, professionalization, and high-quality development of agricultural labor; (4) Accelerate agricultural green technology innovation and guide the green transformation of state farms. This study enriches the theoretical foundation of low-carbon agriculture and develops a framework for assessing carbon emissions in Chinese state farms, offering guidance for future research and policy development in sustainable agriculture.

Challenges to Integrating Portable Magnetic Resonance Imaging Systems in Emergency Medical Service Ambulances for Stroke Care

This qualitative study explores the barriers to incorporating portable MRI devices in ambulances, enabling effective patient triage and potentially reducing time to thrombolytic treatment for stroke. Using a digital twin of the patient handling process, semi-structured interviews were conducted with 11 paramedics and 7 neurologists from an emergency medical services system and a tertiary stroke care center. Thematic analysis of interview transcripts, guided by the Systems Engineering Initiative for Patient Safety framework, revealed key barriers: the need for specialized MRI operation skills, complex patient handling procedures, limited space, and the necessity for training and policy development. The study proposes solutions to address these challenges, aiming to facilitate the implementation of ambulance-based MRI systems for expedited stroke care. The findings contribute to understanding the factors influencing the adoption of advanced imaging technology in pre-hospital settings, ultimately improving patient outcomes by minimizing delays in stroke treatment.

AN INTEGRATED ANALYSIS OF GREEN HIGHWAY ASSESSMENT CRITERIA FOR SUSTAINABLE INFRASTRUCTURE DEVELOPMENT

In line with the Sustainable Development Agenda 2030, all industries are slowly moving toward a greener approach through their activities and practices. The construction industry is a major contributor to overall economic growth as it provides infrastructure and physical facilities for people. However, the activities involved have caused several environmental impacts, such as pollution, climate change, destruction of natural habitats, landfill waste, and overconsumption of global resources. Therefore, this study presents a comprehensive analysis on the infrastructure work, which is the green highway assessment. The assessment criteria and rating methods were derived from seven prominent frameworks, including Greenroads, WISE, GreenLITES, I-LAST, BE2ST, Greenroads Manual, and MyGHI. Moreover, this research evaluates these sustainable criteria across five elements of green highway development: sustainable design and construction activity, energy efficiency, environmental and water management, materials and technology, and social and safety aspects. This research adopted a systematic literature review and comparative analysis to identify commonalities, differences, and gaps in existing assessment frameworks, providing insights into the holistic evaluation of green highways and sustainable infrastructure projects. The findings of this research contribute to advancing the understanding of green highway initiatives, especially in the local context, and policy development in the field of sustainable infrastructure.

Soil pollution in the European Union – An outlook

Soil pollution in the European Union (EU) is poorly quantified, because of several years of reduced attention and limited funding on soil research and monitoring. Moreover, issues such as different monitoring methodologies within Member States (MS), and quantification methods focused on pseudototal rather than the available fraction of pollutants, has been limiting our understanding of risk under soil pollution. Despite that, thanks to efforts from the scientific community, it was possible to achieve some progress, which is by far insufficient for the problem at hand. In the anticipation of future policy demands and towards a common strategy for tackling soil pollution in the EU, it seemed relevant to describe the limited knowledge and main uncertainties. Such analysis should provide evidence for the development of efficient policies, as well as updating current ones to better tackle the interdisciplinary of soil. This perspective provides our view on current knowledge on soil pollution at EU scale, by compiling the most updated assessments made at EU scale, identifying soil pollution drivers, impacts on health and the environment, and evaluating current state of knowledge. Allowing us to infer about current level of uncertainties and knowledge gaps and identify solutions through future research and policies. Our suggestions are in line with an increasing investment on research and innovation, but also more frequent updates of current legislation already tackling pollution and welcoming the new proposal for a Soil Monitoring Law as an important driver for soil knowledge development and implementation of a European monitoring system.

“It’s easier to take a pill than fix a problem:” qualitative analysis of barriers and facilitators to antimicrobial stewardship program implementation in carceral settings

BackgroundWidespread antibiotic prescribing contributes to globally emerging antimicrobial resistance (AMR). Despite stewardship recommendations by the Infectious Diseases Society of America, there is a lack of literature identifying barriers and facilitators to antimicrobial stewardship programs (ASPs) in United States (U.S.) carceral settings.MethodsGuided by the Theoretic Domains Framework, we performed in-depth interviews with 68 key stakeholders in Massachusetts carceral settings to contextualize barriers and facilitators to ASP implementation. We recruited 32 people incarcerated in Massachusetts jails and 36 carceral clinicians, correctional officers/administrators in Massachusetts and other U.S. states, and Massachusetts community clinicians for interviews.ResultsFrom the completed semi-structured in-depth interviews, we identified seven salient themes—four barriers and three facilitators—both specific to and across stakeholder groups. Barriers included the following: (1) jail being viewed as a “dirty place” that increases the risk of infections; (2) variable awareness and knowledge of AMR and ASPs; (3) clinicians’ opposition to change and oversight of their antibiotic prescribing; (4) competing priorities taking precedence over ASP implementation. Facilitators included (5) interest in changing the narrative about carceral healthcare through ASP implementation; (6) opportunities for education about ASP and AMR; and (7) the development of systems, policies, and regulations to improve antibiotic prescribing.ConclusionsTo our knowledge, this is the first qualitative study to leverage broad criminal-legal stakeholder groups to inform the next steps in developing and implementing ASPs in carceral settings in the U.S.

The gender congruences and life satisfaction scale for transgender and gender-diverse youth (GCLS-Y): a validation study with samples from the UK and US

Background There are currently no good quality psychometric tools available to assess multi-dimensional outcomes for trans and gender diverse youth. A tool is needed to develop a stronger evidence base regarding the evaluation of gender-affirming healthcare for the population. Aim The current study aimed to adapt and validate the Gender Congruence and Life Satisfaction Scale for young trans and gender diverse people (GCLS-Y) with young trans and gender diverse people aged 14-19 living in the United Kingdom (UK) and the United States (US). Method Initially, the GCLS-Y was adapted through expert consultation and discussion with trans and gender diverse youth to ensure it is meaningful and relevant. A survey that included the GCLS-Y and other psychometric measures that assessed gender incongruence, mental health and wellbeing to determine convergent validity and social desirability to examine discriminant validity was completed by 307 trans and gender diverse youth (n = 175 in the US and n = 132 in the UK). Findings Exploratory Factor Analysis supported a 5-factor model that was assessed as conceptually accurate. The final version of the GCLS-Y included 38 items with the following subscales: Psychosocial Implications of Gender Distress, Incongruence and Dysphoria related to Chest, Incongruence and Distress related to Genitalia, Social Perceptions of Gender, and Life Satisfaction. The measure was also found to be valid and reliable. Conclusions The GCLS-Y is a psychometrically sound tool that can be used to assess multidimensional outcomes among trans and gender diverse youth (14-19 years) related to mental health and wellbeing, gender incongruence and distress, and social experiences of gender. The tool can support the development of evidence-based policy, which has implications for legislation, healthcare funding, and broader societal attitudes.

EMOTIONAL SOLIDARITY IN TOURISM DEVELOPMENT: HOW POLICY AND KNOWLEDGE DRIVE SUPPORT IN GILGIT BALTISTAN, PAKISTAN

The participation of local communities is vital in developing tourism, as their attitudes and behaviours can significantly impact the growth and success of a destination. As the primary recipients of future tourism developments, the perspectives of local communities should guide the creation of sustainable policies aimed at maximising benefits and minimising negative impacts. The study examines how government policy, tourism knowledge, emotional solidarity, and support for tourism development are interrelated among the residents of Gilgit-Baltistan, Pakistan. Based on a quantitative and cross-sectional research design with two sampling stages comprising quota and purposive sampling, 216 responses from the residents of Gilgit-Baltistan were collected and analysed through Partial Least Square-Structural Equation Modeling (PLS-SEM). It was revealed that government policy and tourism knowledge influence residents' welcoming nature and emotional closeness, and they contribute to their support for tourism development. The findings underscore the importance of establishing targeted and effective support systems between stakeholders to sustain the benefits of tourism development.

Educational equity: the role of student retention rights and policies in human development

Educational equity: the role of student retention rights and policies in human development

Optimizing cropping patterns and resource allocation for sustainable agricultural development: A case study of Ilam province, Iran

Establishing connections between ecosystems and agricultural mechanization can help address erroneous decision-making in agricultural management and prevent further harm to ecosystems. It is essential for authorities and decision-makers in the agricultural sector to understand ecosystem dynamics and influencing factors to develop appropriate policies for sustainable development. This study focuses on identifying optimal conditions for determining crop patterns and input allocation in Ilam province's agricultural practices, considering technical and energy parameters. Cultivating one hectare of wheat and barley in the region requires an average energy consumption of 1.79 GJ from various sources, with an estimated energy output of 38.04 GJ ha−1 for these crops. The research involved farmers cultivating wheat, barley, fodder maize, and canola in the southern region of Ilam province, covering cities like Abdanan, Dareshahr, and Dehloran. The study suggests adjustments to cropping patterns, including reducing wheat cultivation and increasing irrigated fodder maize cultivation under optimal conditions. It also recommends exploring rainfed cultivation or enhancing the yield of rainfed wheat to offset the reduced wheat cultivation. The goal planning model indicates a shift towards sustainability, with changes in cropping patterns focusing on wheat, barley, fodder maize, and canola crops, including expanding the cultivation areas of irrigated wheat, barley, and fodder maize. Efforts aim to enhance the productivity of irrigated crops to promote sustainability and improve agricultural practices in the province for long-term sustainability goals.

Current labor market in the EU and Ukraine: trends, problems, forecasting and solutions

The labor market is one of the economy changing components, it is quite similar to the market for goods and services, but instead of the demand and supply of goods, there is a demand and supply of labor, knowledge, skills and abilities that are supplied by the employee. The EU, in turn, is known for its openness to immigrants and the employment of third-country nationals. This creates new opportunities and challenges for workers and employers. Labor market research helps to understand the impact of immigration on labor markets. Covid-19 has actually become that springboard on the way to changes in the economies and labor markets of countries around the world. Transformations and changes that were just emerging until 2020 (this may safely include digitalization, automation, the spread of remote employment, etc.) will further intensify under the influence of the Covid-19 pandemic and the Russian-Ukrainian war and lead to a significant redistribution of workers between sectors. In general, labor market research in the EU and Ukraine helps countries to understand and respond to various challenges and opportunities related to employment, labor migration, economic development and social policy. The purpose of our work is to identify trends and problems that exist at the present stage of development of the labor market, as well as to forecast the further development of the labor market at the level of the European Union and Ukraine

Immunity through technification? A critical review of water governance discourses in Tunisia

AbstractAfter Tunisia's independence from France in 1956, the country was engaged in what has been termed the “supply management policy”, that is, a maximum mobilization of water resources through large‐scale modern hydraulic infrastructure. Towards the beginning of the 1980s, the country entered a crisis and had to adopt in 1986, under pressure from the International Monetary Fund and the World Bank, a “Structural Adjustment Program” (SAP) that prioritized measures to improve economic efficiency and liberalize the economy. Since then, Tunisian water policy has progressively shifted towards “Integrated Water Resources Management” (IWRM). This review critically analyzes the water governance discourses that have framed these policy interventions. I will draw on academic research and official and civil society reports to suggest that these discourses have been “rendered technical”, stripping issues of any political (and therefore conflicting) character. When rendered technical discourses raise development projects and policies above the terrain of political contestation, the possibilities of action available to those opposed to them become limited. This depoliticization of development interventions through technical discourses narrows the public space of democratic debate. I will also argue that the “technification” (rendering technical) process is reversible. Opposition groups can challenge technical discourses with a critical approach that can reconfigure and alter the trajectory of governmental programs. However, critical discourses can, in turn, be rendered technical.This article is categorized under: Human Water > Water Governance Human Water > Rights to Water

Education policy development in England: Effective ‘mainstreaming’ of SEND provision

Education policy development in England: Effective ‘mainstreaming’ of <scp>SEND</scp> provision