Policy Practice Research Articles

Breastfeeding During COVID-19 Stay-at-Home Orders: Implications for Future Maternal Work Policies and Health Equity.

This study aimed to explore the impact of the COVID-19 pandemic and associated stay-at-home orders on the breastfeeding experiences of U.S. people a identify facilitators and barriers to breastfeeding during this period, and to assess the effects of maternal stress and misinformation on breastfeeding practices. U.S. women with infants were selected through purposive and convenience sampling. An online survey, distributed during summer 2020, measured changes in infant feeding practices, maternal stress levels, use of lactation support resources, and the influence of misinformation on feeding decisions. Quantitative data were analyzed using descriptive statistics, and qualitative responses underwent thematic analysis. Our sample (n = 1,861) revealed that 34% of U.S. women realized the pandemic affected their feeding practices, 544 women provided qualitative data. Major themes from qualitative analysis included ease of breastfeeding at home, bonding, increased breastfeeding duration, and challenges like limited access to lactation support. Logistic regressions highlighted demographic influences on breastfeeding practices, with no significant effects found related to the child's age or women's income on changes in feeding practices. The COVID-19 pandemic substantially impacted breastfeeding experiences of U.S. women, yielding insights for future policy and healthcare practices. The findings underscore the potential benefits of telehealth lactation support services and flexible remote work environments for breastfeeding people. Clear and scientifically-grounded communication regarding breastfeeding, mental health support, and policy development, are essential to promote equitable and flexible work and maternity leave options for breastfeeding people especially during global health crises.

Investigating the role of biomass energy consumption and forest products trade on the forest footprint in Finland: an environmental Kuznets curve analysis

AbstractForests are essential in mitigating climate change by absorbing carbon dioxide and maintaining ecosystems, mainly through preserving biodiversity. For this reason, the sustainability of forests is essential for human life. This paper examines the role of biomass energy consumption, forest product trade, and economic growth on Finland’s forest footprint from 1970 to 2018. By employing Fourier-based unit root and cointegration tests, we confirm the Environmental Kuznets Curve (EKC) hypothesis, demonstrating a long-term relationship in which economic growth first raises, then reduces the forest footprint. Biomass energy consumption and forest products trade show an insignificant long-term effect on the forest footprint. We found unidirectional causality from the forest footprint to biomass energy consumption and economic growth. This research fills a gap by focusing on the under-researched forest footprint within the EKC framework, particularly in Finland’s context of stringent forestry policies. Our findings emphasize the need for interdisciplinary collaboration to enhance environmental policy and sustainability practices. We further contribute to the broader literature on sustainable forest management and offer actionable policy recommendations for enhancing Finland’s environmental strategies.

Forest assisted migration and adaptation plantings in the Northeastern US: perspectives and applications from early adopters

Threats to the future function of forested ecosystems and stability of ecosystem service provisioning due to global change have motivated climate-adaptive forest management strategies that include various forms of tree planting termed “adaptation plantings”. Despite the emergence of these strategies, less is known as to how foresters and other natural resource managers perceive or are engaged with adaptation plantings like forest assisted migration (FAM). This knowledge gap is most pronounced in regions like New England and the North Central US (hereafter, the Northeastern US) where tree planting is less common but expected to be an important forest management tool for adaptation. To address this, we surveyed 33 natural resource managers in this region actively engaged in climate change adaptation (i.e., early adopters of the practice) to assess how tree planting for adaptation is currently being pursued against the perceived barriers, opportunities, and potential future engagement with the strategy. Survey respondents overwhelmingly (93.5%) forecast increases in the future use of adaptation plantings in their work in the region, attributed to increased awareness, acceptance, and interest in the practice. Respondents expressed notable interest in strategies related to diversification and most types of FAM (e.g., assisted population expansion and assisted range expansion), but hesitancy to engage with more contentious planting types like afforestation or FAM linked to the long-distance translocation of exotic species (e.g., assisted species migration). Although examples of local enrichment plantings (i.e., non-FAM) proliferate, nineteen of the top twenty most common tree genera planted contain at least one example of FAM in the study region. The most notable barriers reported were themed as 1) biotic and abiotic, 2) information and material, and 3) policy, social, and economic factors. While most respondents report difficulty obtaining adequate planting material from nurseries (i.e., seedlings), over 80% placed orders shortly before planting (< 1 year) which likely generates difficulty in sourcing seedlings suited for a specific site and future range of environmental conditions. Although this study is limited by focusing on subset of natural resource managers who are early adopters of climate change adaptation within the region, valuable inferences into the barriers and trends are possible from this population serving on the front lines of forest adaptation. Together, these results from early adopters suggest a potentially growing need for allocating resources that engage forest stewards in adaptation planning and serve to refine policy, financing, and management practices to support this adaptation strategy in this region and beyond.

Enhancing Environmental Awareness for Sustainable Retail: Analysis of the Buy-Online-and-Return-in-Store Policy Adoption Using Theory of Planned Behavior

This study explores the context of buy-online-and-return-in-store (BORS) policy from an environmental perspective and conducts a comprehensive analysis through the theory of planned behavior (TPB). Adding environmental awareness and awareness of consequences provides a new perspective on how sustainable practices can be enhanced through an omni-channel retail strategy. Survey responses from 405 participants were analyzed using structural equation modeling. Results show that attitudes, subjective norms, and perceived behavioral control are key determinants of practical BORS policy. The study found that environmental awareness significantly influenced BORS adoption directly and indirectly by enhancing perceived behavioral control, whereas consequence awareness primarily affected adoption by shaping consumer attitudes. Compared with consumers who choose to return online, consumers who prefer in-store returns show higher environmental awareness, highlighting the environmental advantages of BORS. In addition, the BORS policy improves overall shopping satisfaction by integrating the convenient process of online purchases and offline returns, allowing consumers to switch freely between different channels. These findings provide valuable insights for retailers and policymakers seeking to promote sustainable consumer behavior to effectively promote the importance of sustainable retail practices.

Centering Social Justice and Equity in Research on Accessibility to Public Buildings for Individuals with Mobility Disabilities: A scoping review.

To explore how principles of social justice and equity are integrated into research concerning accessibility to public buildings for individuals with mobility disabilities. Utilising a scoping review methodology to assess literature based on the criteria set by the Joanna Briggs Institute, seven databases were screened. Studies were selected using the framework: "persons with mobility disabilities" AND "accessibility" AND "public buildings". A theoretical framework helped to extract codes and develop themes through an inductive-deductive analysis method. The results are presented descriptively. The examination of 84 studies uncovered a complex interplay between agencies, systemic challenges, discriminatory practices, and societal attitudes perpetuating marginalisation of individuals with mobility disabilities in their access to public buildings. The recommendations emphasize importance of practical measures, research imperatives, and policy developments to promote inclusivity. We present a 'Ten-step approach' to integrate social justice and equity into research on accessibility in public buildings for people with mobility disabilities. Integrating diversity, active participation, and inclusive methodologies are essential to address systemic issues, discriminatory practices, and societal attitudes that hinder accessibility and inclusion. Collaborations with diverse stakeholders are crucial for policy changes, resource allocation, and advancing social justice and equity in accessibility research and practice.

The Effects of Health Insurance on Demand for Healthcare Services in Tanzania

ABSTRACT: Consistent healthcare financing systems within a particular nation or community have been regarded as vital for making universal healthcare access. This study intended to examine the influence of health insurance on the demand for healthcare services and the influence of socio-economic, demographic and hospital-related factors on demand for health care services in Tanzania context. The study employed secondary data, which were analysed by descriptive statistics and the results were presented in tables and percentages. Econometric analysis was also done using binary probit regression model to determine the factors influencing demand for health care services in Tanzania. The instrumental variable was applied to address the problem of endogeneity of health insurance. The regression results revealed that gender, education level, household size, income, treatment cost, perceived health quality and health insurance type were significant and positively linked with demand for health care services. However, marital status was also significant but negatively associated with the demand for healthcare services. The study concluded that, despite of the efforts made by the government and other stakeholders on emphasis over having health insurance, the enrolment to health insurance schemes is still low although it has been noted to significantly influence the demand for health care services. Lastly, the paper recommends that the government and other stakeholders are required to formulate or strengthen the formulated policy in practice, purposively to improve access, affordability and the quality of health care services. Governmental and non-governmental organizations (NGO`s) and other stakeholders should put more effective strategies to improve coverage but also reduce the financial burden caused by illness. Also, the government needs to subsidize the healthcare sector, especially to the poor and provide subsidies to private healthcare facilities, improvement of insurance type, specifically, the NHIF which needs to increase coverage. Furthermore, health care managers should educate other people and make a clear observation on factors that make individuals demand for health care because they have a great role in the health care sector as well as strategies to improve household`s income to meet the health needs in Tanzania.

Education Policy as Public Policy

This article examines the education policy currently implemented in Poland through the lens of understanding, characteristics, and functions of public policy. The analysis is framed within a metatheoretical perspective, referencing the concept of long duration. To illustrate the practice of education policy as a form of public policy, determinations have been made regarding the nature of public policy, its theoretical foundations, aims, and practical priorities. The conclusion highlights selected examples of actions and phenomena that illustrate how education policy deviates from public policy principles, along with research examples that provide theoretical foundations for the desired changes.

Unveiling the Value of Meta-Analysis in Disease Prevention and Control: A Comprehensive Review.

Given the plethora of studies today that focus on the same topic, clinicians and other healthcare professionals increasingly rely on meta-analysis to aid in their evidence-based decision-making. This research method, which combines data from multiple studies to produce a single, more precise estimate of effect size, is invaluable for synthesizing evidence, resolving inconsistencies and guiding clinical practice and public health policies. Especially in disease prevention and control, meta-analysis has emerged as a critical tool. Meta-analysis is particularly valuable in assessing the effectiveness of preventive interventions such as vaccines, lifestyle modifications and screening programs. It provides robust evidence that supports the implementation of effective preventive measures and the discontinuation of ineffective or harmful ones. Furthermore, meta-analysis provides evidence to develop clinical practice guidelines, ensuring patients receive evidence-based treatments. In addition, public health policies aimed at disease prevention and control often rely on evidence from meta-analyses, which provide the data needed to justify and design large-scale public health initiatives. This comprehensive review delves into the role of meta-analysis in disease prevention and control, exploring its advantages, applications, challenges and overall impact on guiding clinical practice and public health policies. Through case studies and an examination of future directions, this paper underscores the pivotal role of meta-analysis in disease prevention and control.

Overview of Governance and Rampant Corruption in Land Administration in Bangladesh

This study focuses on the governance and corruption in the land management system of Bangladesh and the effect of these factors on the tenure security of land and the country’s economic growth. This study used a quantitative research design. The research outcomes show that corruption is systematic in all levels of land management, thus eroding the security of tenure, and worsening social inequalities. The new governance reforms have also been implemented to curb corruption; however, these changes’ impact has been rather poor. In light of the findings of the study, there is a well-established need for systematic reform to improve the situation in Bangladesh through digitization of land records, better transparency, and higher accountability in the land administration sector. The investigation presented in this research adds to the discussion of governance and development and offers practical policy suggestions that relate to fighting corruption and enhancing the efficient utilization of Bangladeshi land.

Spontaneous Formation of Evolutionary Game Strategies for Long-Term Carbon Emission Reduction Based on Low-Carbon Trading Mechanism

In the context of increasing global efforts to mitigate climate change, effective carbon emission reduction is a pressing issue. Governments and power companies are key stakeholders in implementing low-carbon strategies, but their interactions require careful management to ensure optimal outcomes for both economic development and environmental protection. This paper addresses this real-world challenge by utilizing evolutionary game theory (EGT) to model the strategic interactions between these stakeholders under a low-carbon trading mechanism. Unlike classical game theory, which assumes complete rationality and perfect information, EGT allows for bounded rationality and learning over time, making it particularly suitable for modeling long-term interactions in complex systems like carbon markets. This study builds an evolutionary game model between the government and power companies to explore how different strategies in carbon emission reduction evolve over time. Using payoff matrices and replicator dynamics equations, we determine the evolutionarily stable equilibrium (ESE) points and analyze their stability through dynamic simulations. The findings show that in the absence of a third-party regulator, neither party achieves an ideal ESE. To address this, a third-party regulatory body is introduced into the model, leading to the formulation of a tripartite evolutionary game. The results highlight the importance of regulatory oversight in achieving stable and optimal low-carbon strategies. This paper offers practical policy recommendations based on the simulation outcomes, providing a robust theoretical framework for government intervention in carbon markets and guiding enterprises towards sustainable practices.

COMPARISON OF SOCIAL POLICY PRACTICES IN OECD COUNTRIES WITH PANEL ANALYSIS

This study employs a panel data analysis method to examine the impact of social policy practices in OECD countries on economic development levels. The advent of the Industrial Revolution and subsequent technological developments have led to a widening of the development gap between countries. The study examines the relationships between governance components and gross domestic product (GDP) in detail. Governance is a pivotal factor in the formulation of social policies, with the involvement of the state, private sector and non-governmental organisations. The study demonstrated the impact of the rule of law and other governance components on economic growth. It has been argued that governance practices and social policies have a significant effect on development on a global scale.

The itinerary of children in search of healthcare: A scoping review and proposal of an explanatory model.

This scoping review mapped the academic literature focused on the therapeutic itinerary of children who seek care in health services and proposed an explanatory model to expand the concept and classification of these health itineraries. A total of 789 articles were reviewed, of which 28 were eligible for inclusion. In these 28 it was possible to observe that the child's therapeutic itinerary is more than a physical path, but also encompasses all choices within a specific social and cultural environment in which the child is inserted. Our proposal is to expand the concept beyond the therapeutic, classifying the itinerary also according to the objective, the decision-making agent, respect for the presence of company, the health subsystem used, according to the physical continuity of the itinerary, the perception of efficacy of the patient, the nature of the illness, the administration of healthcare, the means of transport used, the person providing information about the itinerary, the planning of the itinerary and its completeness. Knowing the child's itineraries toward healthcare allows the development of innovative discourses and practices for future public policies, through which the principles of comprehensiveness and resoluteness in children's health would be strengthened. There is still a need to deepen knowledge about the meanings and feelings regarding their interpretations of the events suffered in childhood.

Carbon emission characteristics and carbon reduction analysis of employee travel-taking a research institute as an example

This paper adopts the “baseline scenario method” to construct a comprehensive model for calculating and reducing carbon emissions generated by employee travel, including the accounting of carbon emissions from commuting and business travel, as well as the assessment of green travel for carbon reduction. The study employs methods such as questionnaires and on-site interviews to collect travel data from employees of a research institute in Beijing as a case study. The results show that employees’ commuting methods are diverse, with the subway being the primary mode of travel; however, business travel generates higher carbon emissions, particularly among employees with higher education levels. The research concludes that the model proposed in this paper provides a framework for preliminary carbon emission estimation, but to improve the accuracy of the estimates, more variables and factors need to be considered, and the limitations of the model are pointed out. The research findings have significant implications for policy and institutional practices, suggesting the adoption of more targeted measures to reduce the use of high-carbon-emission travel methods and to encourage the use of green travel options. With the continuous advancement of data collection technologies in the future, it will be possible to further establish a more refined carbon emission accounting model and obtain more accurate and comprehensive travel data, thereby providing solid data support for the development of more effective carbon reduction strategies and policies.

LGGL-01 “INTERVENTION OUTCOMES OF ENHANCED RECOVERY AFTER SURGERY PROTOCOL VERSUS STANDARD CARE FOR GLIOMA PATIENTS IN SELECTED HOSPITALS IN DEMOCRATIC REPUBLIC OF THE CONGO: RANDOMIZATION AND STRATIFICATION OF PROVIDERS AND HOSPITALS”

Abstract Enhanced Recovery after Surgery (ERAS) protocols aim to improve perioperative care and patient outcomes. A pragmatic, multicenter, randomized controlled trial will be conducted in the Democratic Republic of Congo (DRC) to assess ERAS’ efficacy compared to the current standard of care (SOC) for glioma patients. Eligible providers will be randomized at the surgical team level to ERAS or SOC, ensuring consistent practices within teams. Hospitals representing diverse healthcare settings will be included, and randomization will be stratified by hospital to ensure balance. 100 glioma patients (50 in each group) will be included, and primary analysis expects fewer post-operative complications and shorter hospital stays in the ERAS group, with higher patient satisfaction. Subgroup analyses will be conducted by hospital center. Randomization and stratification aim to mitigate provider and hospital-specific influences, enhancing the study’s validity and equitable representation. This unique trial design seeks to provide insights into ERAS benefits for glioma patients in resource-constrained settings, guiding clinical practice and healthcare policy to improve care and outcomes.

Evolutionary game analysis of multi-agent cooperation strategy analysis in agricultural water conservancy PPP project under digitization background

This study constructed a system dynamics (SD) evolutionary game model, from which we analyzed the conditions that need to be met by multi-agents to achieve cooperation in agricultural water conservancy (AWC) Public-Private Partnership (PPP) projects. Simultaneously, this study used numerical simulation to depict the impact of initial participation willingness, reward, punishment, income, and other parameters of local governments, project enterprises, and farmers on the evolution strategy. The results firstly showed that the basic conditions for tripartite cooperation are to strengthen the rewards and punishments for project enterprises and improve the participation benefits of farmers. Secondly, it showed that increasing the rewards for farmers and improving the project dividend benefits can effectively motivate farmers to participate. Thirdly, it showed that enhancing the incentive subsidies and reputation benefits for project enterprise’s participation, as well as strengthening the supervision of local government, boosts the motivation of project enterprises significantly. However, it is vital to ensure that the reward amounts are not too high to allow local government to play its guiding role efficiently. Lastly, the results indicated that digital technology can help reduce the participation cost of local government, project enterprises and farmers, and improve the external reputation benefits of each participant, thus forming a win-win situation for all three participants. Analyzing the cooperation strategies of the three parties in AWC PPP projects provides theoretical support and a decision-making basis for the efficient operation of AWC PPP projects under the digital background, and also provides practical policy recommendations for the high-quality development of AWC.

Wood-based policies as a driver for the climate transition

Abstract In the context of global accelerating urbanization, the total floor area of buildings is expected to double by 2060, with a significant impact on the environment. While cities made consistent progress towards increasing energy efficiency, accounting for, and reducing embodied emissions for new and renovated constructions represents one critical priority for mitigating this impact and reaching genuine carbon neutrality. Wood is a renewable and carbon-positive material, which can have a meaningful contribution to changing paradigms on net-zero carbon ambitions of cities, but still faces the challenge of an immature integration into urban development policy framework. Through the Horizon 2020 “Build-in-Wood” project we addressed the challenge of translating novel wood building systems, pilots, wood value chains for the construction of multi-storey wood buildings, and promising practices into policy. As a result, we formulate transferable lessons learned, recommendations, and criteria that can serve as guidance for municipalities and policymakers who aim to channel their efforts toward creating a more sustainable built environment by prioritizing wood, either implicitly or explicitly. We achieved this by working on understanding the real needs of cities and territories, the drivers, and the key entry points and preconditions for new policies supporting multi-storey wood buildings and genuine carbon neutrality. Specifically, the findings are based on the close collaboration with seven affiliated cities (Early Adopter Cities in Europe), outlining and integrating the results of (i)Multi-criterial urban planning, strategic and regulatory context analysis, (ii)Participatory and co-design approaches implemented with their local stakeholder ecosystem from the wood construction value chains and (iii)Research of different best practice policies at national, regional and local level from different parts of the globe, that incentives through informative, financial, research or regulatory instruments building with wood. The entire process is presented in the form of a Build-in-Wood Policy Catalogue [1], offering insights on working with Early Adopter Cities and guidance for improving policy, governance, and the decision-making process for subnational governments. The research was not intended to be exhaustive in documenting all existing policies because of the field’s dynamics, but rather to provide an overview and understanding of different policy instruments’ applicability and potential impact.

Collaboration for Lead Poisoning Prevention in Puerto Rico.

In 2010, Puerto Rico experienced a cluster of childhood lead poisoning cases stemming from parental occupational exposure to lead. Following the immediate response to this crisis, a dedicated coalition of pediatricians and public health practitioners sustained a collaborative effort to advance pediatric environmental health initiatives across Puerto Rico. Their commitment laid the groundwork for the establishment and evolution of Puerto Rico's comprehensive Childhood Lead Poisoning Prevention and Blood Lead Level Surveillance Program. This compelling case study showcases the potential for concerted, multidisciplinary action to leverage an acute event to influence public policy and clinical practice to promote children's health. By drawing on the lessons learned and strategies used in Puerto Rico, other jurisdictions can overcome challenges in pursuit of enhanced secondary lead poisoning prevention measures, with the goal of achieving primary prevention in the near future.

RETRACTION: Oncologic, Fertility, and Obstetric Outcomes With MPA Therapy in Women with Endometrial Cancer and Atypical Endometrial Hyperplasia.

A. Takeda , Y. Yamamoto , K. Tamura , H. Aoki , H. Noguchi , S. Minato , S. Kamada , R. Arakaki , T. Kaji , and T. Iwasa , "Oncologic, Fertility, and Obstetric Outcomes With MPA Therapy in Women with Endometrial Cancer and Atypical Endometrial Hyperplasia," The Journal of Obstetrics and Gynaecology Research 50, no. 4 (2024): 633-638, https://doi.org/10.1111/jog.15872. The above article, published online on 28 December 2023 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors; the journal Editor-in-Chief, Hiroaki Kajiyama; and John Wiley & Sons, Australia, Ltd. The retraction has been agreed upon following an investigation into concerns raised by a third party, which revealed major conceptual overlap and significant primary data redundancy with a previously published article by an overlapping group of authors. Such publishing practice is against the journal's policy and Wiley's Best Practice Guidelines on Research Integrity and Publishing Ethics.

Policy and Practice of Listening in Secondary English Education: A Critical Reflection from Bangladesh

The current National Curriculum 2012 of English (VI- X) in Bangladesh incorporates both listening and speaking skills for its English education. Textbooks have also been designed in accordance with the policy which is set by the National Curriculum and Textbook Broad (NCTB). The English textbook, titled English for Today (EfT), was designed in alignment with the current National Curriculum for English (VI-X) for students in grades 6 through 10. The target of the EfT is to achieve students’ competency in integrated four skills of English language: listening, speaking, reading, and writing. However, although the listening module is now in policy and classroom practice, it is neither assessed in school or in public exams at the secondary level (Kabir, 2020). This study explores the perceptions of policy and practice of listening in secondary English education in Bangladesh. This study may be significant as little research has been done in Bangladesh on listening skill and its significance for language competence, let alone on the teaching of listening in connection to language learning. This qualitative study is based on in-depth interview data collected in 2019. The interviews included pertinent participants of policymakers and secondary English teachers. The findings indicated that there was a disconnect in curriculum, classroom practice and assessment in secondary English education.

Bio-Conversion Of Plastic Waste Into Sustainable Biofuels: A Comprehensive Review Of Microbial Degradation Approaches

Plastic's pervasive presence in contemporary society has revolutionized industries and daily life but has concurrently birthed environmental concerns necessitating innovative and sustainable solutions. This review navigates recent strides in plastic-to-fuel conversion, with a particular focus on the transformative potential of microbial degradation. Beginning with a critical assessment of environmental challenges linked to conventional plastic disposal, this review meticulously dissects microbial degradation. Unveiling the intricate processes orchestrated by bacteria and fungi, it delves into the unique advantages this method offers, including reduced land dependency, cost efficiency, and minimal environmental impact, setting it apart from traditional approaches like pyrolysis and gasification. Navigating challenges inherent in plastic-to-fuel conversion, such as energy consumption and emissions, this review synthesizes the latest research, technological breakthroughs, and ongoing initiatives. It culminates in a comprehensive overview of microbial degradation's potential for sustainable plastic waste management and biofuel production. As a synthesis of cutting-edge knowledge, this review not onlyq1 informs current scientific discourse but also charts course for future research, policy, and industrial practices, steering towards a harmonious equilibrium between the benefits of plastic and environmental considerations. This work serves as a beacon for those dedicated to fostering a sustainable future through a nuanced understanding of plastic waste management, environmental sustainability, and the evolving landscape of biofuel production.