Public Interventions Research Articles

(Re)Writing the City from Within: An Exploratory Approach to Sustainable Urban Morphologies from the Dialogue Between Public Space and Public Transport in Barcelona’s Trambesòs

Research on urban transport and mobility through everyday practices has generated new theoretical and methodological approaches to achieve more sustainable urban morphologies. This paper focuses on the characterization of the process of urban (re)qualification through the binomial of public space–public transport, based on the analysis of Trambesòs tramway in Barcelona, from 2004 to the present. This methodology consisted of an exploratory morphological analysis that identified patterns derived from punctual interventions, articulation axes, and saturation pieces in the urban fabric. The results revealed three main morphological patterns: the configuration of a particular character in each public space intervention associated with the tramway, the morphological improvement and dynamization of the urban fabric, and the transformation of the city’s image through the standardization of accessibility conditions, a key social sustainability indicator. In the discussion, the results are triangulated with the concepts of urban morphology and social processes and compared with quantitative studies, which can serve as a foundation for further in-depth research. In conclusion, the tramway has facilitated a transition from urban discontinuity and segregation to continuity and cohesion, highlighting the impact of the public space–public transport binomial on more sustainable urban morphologies. This contributes to how urban morphological analysis provides new approaches to understanding public transport as an extension of public space and support for urban habitability.

A novel spatio-temporal prediction model of epidemic spread integrating cellular automata with agent-based modeling

Since 2019, major infectious disease outbreaks have placed tremendous pressure on global public health systems, triggering extensive research on the predictive modeling of infectious diseases. Cellular Automaton (CA) is primarily used in the spatial prediction of infectious diseases to establish a model to for simulating the interaction between different regions and the infection risk to simulate the transmission process of the disease and predict its development trend. However, CA models are governed by initial fixed rules and local interactions, and often fail to capture the complex dynamics of epidemic transmission, which are influenced by factors such as public behavior and government intervention. In view of these limitations, we propose a factorial simulation model for the spatial spread of epidemics, the CA-ABM, which divides agents into three categories–public, government, and hospital agents–to comprehensively express the macro factors that affect the development of epidemics. Agent-Based Modeling (ABM) influences the transition rules of the CA through agent choices, constraints and supporting behaviors. Focusing on the COVID-19 pandemic in mainland China from February 6 to March 20, 2020, we simulate its spread. The results showed an average improvement of 8.4 % in prediction accuracy, with few errors, RMSE under 200, and R2 values over 0.9 in most provinces, demonstrating strong macro-scale stability. This approach helps regions to understand influencing factors and enables targeted infection risk assessment and prevention. In addition, scenario analysis based on CA-ABM model changes epidemic decision-making from “prediction-response” to “scenario-response” and provides theoretical reference for future epidemic management.

A Multifaceted Exploration of Status Asthmaticus: A Retrospective Analysis in a Romanian Hospital

Background: Status asthmaticus is a severe, life-threatening asthma exacerbation requiring urgent medical intervention. This study aims to examine its epidemiology in Timis County, Romania, over 11 years. Methods: A retrospective analysis was conducted using hospital records from 2013 to 2023, focusing on demographic, geospatial, and temporal distributions. Network analysis of the recorded comorbidities was used to identify phenotypic clusters among patients. Results: Females and older adults were disproportionately affected. Several triggers and geospatial patterns were identified. Five phenotypic clusters were determined: two in the T2-high endotype, two in T2-low, and a mixed one. Conclusions: The findings highlight the need for personalized asthma management strategies and public healthcare interventions in Timiș County, addressing specific demographic and geospatial factors. This study also provides a valuable reference for similar regions.

Trust in Government and COVID-19 Preventive Behaviors

High levels of trust are positively correlated with increased collaboration, prosocial actions, and heightened adherence to preventive behaviors during the COVID-19 pandemic. Previous studies on trust during the pandemic have primarily focused on either cross-sectional data or its impact in conjunction with other related variables, such as political party affiliations or vaccine availability. In this study, we employed a national survey panel comprising data from 760 individuals interviewed at three intervals between July 2020 and January 2021. We used pooled datasets, panel datasets, and dependent variable lags to control for time-invariant unobservable variables and endogeneity. Our findings reveal that trust in government influences individuals’ behavior when they are requested to follow public interventions. Notably, trust in local government is associated with increased adherence to COVID-19 preventive behaviors, similar to the effect observed with an annual income exceeding $100,000.

Association of Area Deprivation Index With Mortality in Critically Ill Adults With COVID-19.

Various social determinants of health have been established as significant risk factors for COVID-19 transmission, prevalence, incidence, and mortality. Area deprivation index (ADI, a composite score made up of educational, housing, and poverty markers) is an accepted multidimensional social determinants of health measure. Little is known about how structural social determinants of health before hospitalization, including ADI, may affect mortality related to COVID-19 in critically ill patients. To examine the association of ADI with intensive care unit (ICU) mortality in patients with COVID-19 and compare its predictive power with that of clinical factors. This was a retrospective cohort study of critically ill adults with COVID-19 in 3 hospitals within a single health system. Multivariable logistic regression models (adjusted for demographic and clinical variables) were used to examine the association of ADI with ICU mortality. Data from 1784 patients hospitalized from 2020 to 2022 were analyzed. In multivariable models, no association was found between national ADI and ICU mortality. Notable factors associated with ICU mortality included treatment year, age, van Walraven weighted score, invasive mechanical ventilation, and body mass index. In this study, clinical factors were more predictive of mortality than ADI and other social determinants of health. The influence of ADI may be most relevant before hospital admission. These findings could serve as a foundation for shaping targeted public health strategies and hospital interventions, enhancing care delivery, and potentially contributing to better outcomes in future pandemics.

DEVELOPMENT-ECONOMIC FREEDOMS INTERACTION: A COMPARATIVE ANALYSIS OF D8 AND G8 COUNTRY GROUPS

One viewpoint, which has been gaining traction recently, posits that augmenting economic freedom within liberal markets while minimizing public intervention spurs development. Conversely, another standpoint suggests that as development progresses, there emerges a heightened demand for greater economic freedom, resulting in the implementation of liberal policies. In this context the primary objective of this study is to scrutinize the presence of causality between economic freedom and development. Additionally, the study delves into whether this causal relationship, if extant, is consistent across countries at varying stages of development. Consequently, an examination is conducted on two distinct country groups, namely D8 and G8, employing the Dumitrescu-Hurlin panel causality test. This method dissects the directional link between economic freedom and development for these country clusters spanning the period 2000-2019. The analysis reveals that within D8 nations, a reciprocal causality exists between economic freedom and development. In contrast, among G8 countries, no causal link emerges from economic freedom to development, while a unilateral causal relationship emerges from development to economic freedom.

Ultra-processed food consumption and risk of coronary heart diseases: UK Whitehall II cohort study

Abstract In recent decades, ultra-processed foods (UPFs) intake has increased drastically, sparking concerns about their potential impact on cardiometabolic diseases. However, large-scale cohort studies tracking UPF consumption at multiple time points remain limited. This study explores the prospective association between repeated measures of UPF intake and the risk of coronary heart disease (CHD), along with its secondary endpoints, within the UK Whitehall II study. The analytical sample tracked 7,138 midlife British participants without CHD from baseline. UPF consumption was measured using validated food frequency questionnaire (127 items) and classified by the NOVA system during three phases: 1991/1994 (phase 3), 1997/1999 (phase 5), and 2002/2003 (phase 7). This study assessed the onset of CHD and its secondary endpoints, including CHD and all-cause mortality, through medical exams and hospital records up to 2016 and 2021, respectively. Cox proportional hazards regression models adjusted for socio-demographics, lifestyle factors and total energy intake were used to explore the prospective association between cumulative average UPF intake (in quintiles) and CHD outcomes. During a median follow-up of 13 and 19 years, 589 cases and 1,314 deaths were documented. In multivariable adjusted cox models, the highest UPF consumption quintile versus the lowest quintile was associated with higher CHD incidence [HR:1.26; 95% Confidence Interval (CI): 1.02-1.55; p = 0.03]. Additional adjustment of total energy intake increased the CHD risk by 28% [HR:1.28; 95% CI: 1.03-1.58; p = 0.02]. No significant relationships were found between cumulative average UPF intake and CHD or all-cause mortality. In UK midlife adults, higher UPF intake is prospective associated with increased CHD risk. Although additional research is warranted, these findings emphasize the importance of public awareness and food policy interventions to reduce UPF intake for alleviating the population burden of CVD. Key messages • Our study suggests the need for increased efforts to implement population wide strategies on regulating food processing, such as taxation and front of package warning labelling of UPF. • Our study emphasizes UPF’s role in cardiovascular prevention, highlighting the need for nutrition counseling on UPF consumption for those at risk of CVD.

Public measures to reduce the consumption of added sugars and their impact on the occurrence of oral diseases: an integrative literature review

The consumption of added sugars has increased globally, influencing the high prevalence of chronic non-communicable diseases (NCDs), including oral diseases such as tooth decay and periodontitis, highlighting the need for effective public policies to control the consumption of sugary products. This work aimed to identify whether external public interventions to reduce the consumption of sugary products impact the occurrence of chronic oral diseases, being an integrative literature review. The electronic search was carried out in the SciELO, Cochrane and PubMed databases, using the English descriptors “sugar sweetened drink”, “sugar, public health” and “oral health” and their Portuguese counterparts. The application of taxes on sugary products, especially drinks, was the most investigated public measure, showing a positive effect on caries control. However, more studies are needed to draw concrete conclusions about its effectiveness in preventing and controlling periodontitis. Although taxation is effective for cavities, public policies that facilitate access to a healthy diet for the vulnerable population

Functional Capacity of Institutionalized Older People and Their Quality of Life, Depressive Symptoms and Feelings of Loneliness: A Cross-Sectional Study.

The increasing number of institutionalized older individuals worldwide stresses the need to evaluate the association between the functional profile of institutionalized older adults and their quality of life (QoL), depressive symptoms and feelings of loneliness. A cross-sectional study was conducted in 19 residential facilities in Alentejo, Portugal. Between March and September 2023, all individuals aged ≥65 years were invited to complete a structured questionnaire (n = 1303). Sociodemographic and clinical data were collected, and validated scales for the Portuguese older population were used. Linear regression and unconditional binary logistic models were computed. The highest level of dependence was observed in the self-care dimension (mean (SD) = 2.93 (1.21)), with 40% of participants exhibiting levels of dependence requiring daily care or total replacement. QoL was inversely associated with functionality in all dimensions, as well as with severe or complete dependence, even after adjusting for sex, age and education. Participants with depressive symptoms and feelings of loneliness were, respectively, three and two times more likely to be dependent on care (adjusted OR = 3.69, 95% CI: 1.80-7.52; adjusted OR = 2.04, 95% CI: 1.07-3.87). Public policies and interventions should include social and emotional support strategies alongside traditional medical interventions.

The association between county-level premature cardiovascular mortality related to cardio-kidney-metabolic disease and the social determinants of health in the US.

Cardio-kidney-metabolic (CKM) syndrome is defined by the American Heart Association as the intersection between metabolic, renal and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality and recent trends in the US is essential for developing targeted public interventions. We collected state-level and county-level CKM-associated age-adjusted premature cardiovascular mortality (aaCVM) (2010–2019) rates from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER). We linked the county-level aaCVM with a multi-component social deprivation metric: the Social Deprivation Index (SDI: range 0–100) and grouped them as follows: I: 0–25, II: 26–50, III: 51–75, and IV: 76–100. We conducted pair-wise comparison of aaCVM between SDI groups with the multiplicity adjusted Wilcoxon test; we compared aaCVM in men versus women, metropolitan versus nonmetropolitan counties, and non-hispanic white versus non-hispanic black residents. In 3101 analyzed counties in the US, the median CKM associated aaCVM was 61 [interquartile range (IQR): 45, 82]/100 000. Mississippi (99/100 000) and Minnesota (33/100 000) had the highest and lowest values respectively. CKM associated aaMR increased across SDI groups [I – 45 (IQR: 36, 55)/100 000, II- 61 (IQR: 49, 77)/100 000, III- 77 (IQR: 61, 94)/100 000, IV- 89 (IQR: 70, 110)/100 000; all pair-wise p-values < 0.001]. Men had higher rates [85 (64, 91)/100 000] than women [41 (28, 58)/100 000](p-value < 0.001), metropolitan counties [54 (40, 72)/100 000] had lower rates than non-metropolitan counties [66 (49, 90)/100 000](p-value < 0.001), and non-Hispanic Black [110 (86, 137)/100 000] had higher aaMR than non-Hispanic White residents [59 (44, 78)/100 000](p-value < 0.001). In the US, CKM mortality remains high and disproportionately occurs in more socially deprived counties and non-metropolitan counties. Our inability to reduce CKM mortality rates over the study period highlights the need for targeted policy interventions to curb the ongoing high burden.

Current constraints to reconcile tropical forest restoration and bioeconomy

AbstractLarge-scale forest restoration is vital for delivering a broad array of ecosystem services benefits to society. However, it is often perceived as an economically noncompetitive land use choice. Integrating economic opportunities into restoration aligns socioeconomic and environmental goals, reducing conflicts between forest production and conservation-oriented management decisions. Supply chains focusing on high-value goods can enhance the reach of forest restoration efforts and unite ecological and economic benefits in a multifunctional manner. The bioeconomy has emerged as a potential but critical driver for attracting investments in restoration. We outline the challenges and solutions to reconcile forest restoration and bioeconomy, specifically about (i) native timber production, (ii) non-timber forest products, (iii) biotechnological products, and (iv) intangible ecosystem services. This requires collaborative and multidisciplinary efforts to improve investment in large-scale projects. The intricacies of these issues intersect with research development, market dynamics, legal frameworks, and regulatory paradigms, underscoring the necessity for nuanced and tailored public policy interventions. These integrated approaches should enable tropical countries to lead the global forest-based economy and usher in a new era of forest restoration. Graphical abstract

The role of open enterprises in overcoming the Middle-Technology Trap

This paper aims to unveil the role of openness in fostering enterprises to achieve technological progress. By conducting a comparative analysis of Chinese and Western companies’ supply chain strategies in the internet and new energy industries, the article finds that American enterprises have a higher level of supply chain openness than Chinese enterprises in both two industries. Based on the case analysis, that paper argues that openness plays a vital role in promoting technological innovation in enterprises. The profound influence of openness in promoting technological advancement may be observed through three aspects: openness at the technical level, openness in attracting talent, and openness in facilitating the development of rules and regulations. Accordingly, suggestions are proposed to assist Chinese enterprises in avoiding the “Middle-Technology Trap” through openness on the basis of legislation and public policy intervention. Meanwhile, the Chinese government is suggested to promote national coordination to establish a national unified market to realize the three levels of openness of the supply chain and industrial chain strategies: enterprise-level, domestic regional level, and international level.

“Because we’re dying in here”: A study of environmental vulnerability and climate risks in incarceration infrastructure

This article draws on the stories of formerly incarcerated people to examine the ways in which the physical and social infrastructures of carceral facilities increase incarcerated people's vulnerability to environmental hazards exacerbated by climate change. We present qualitative data from interviews and focus groups with people who have been incarcerated in prisons and/or jails in Colorado regarding their experiences with incarceration infrastructure, amplifying the voices of formerly incarcerated people to identify vulnerabilities which have been deliberately hidden by carceral social and institutional processes, and adding them to the academic dialogue around incarceration and climate change. By providing testimony on the ways in which incarceration infrastructure—how they are designed, built, and maintained—amplify environmental harm, we identify how incarceration infrastructures create environmental vulnerability along axes of temperature, air quality, and water supply even before incarcerated people are exposed to climate hazards. Then, we illustrate ways incarcerated people encounter limits to their agency to mitigate this vulnerability, suggesting the need for structural change. Finally, we provide evidence that climate-related extreme temperatures, wildfires, and flood events experienced by our participants exploited the axes of vulnerability laid out above, affecting the majority (65%) of our 35 study participants. Overall, we argue current carceral infrastructure creates material realities that regularly cross the threshold of cruel and unusual punishment, and our argument supports decarceration as a necessary public policy intervention for robust, just, and humane climate resilience.

A participatory research to assess how a student citizens’ assembly can facilitate the co-creation of nutrition interventions in higher education settings

BackgroundThe transition period from adolescence to early adulthood is critical for developing new nutritional behaviors, making higher education students an important target group for public health nutrition interventions. Given the complexity of nutrition-related behaviors and their various determinants, involving the student population (the future beneficiaries of interventions) and the partners engaged in their implementation when designing campus nutrition interventions is essential. Citizens’ assemblies are deliberative processes which are more and more frequently organized to co-create solutions to complex problems. This study aims 1) to design and implement a student citizens’ assembly using participatory research methods, 2) to describe its process and evaluate its transferability, 3) to evaluate changes in dietary habits, knowledge and citizen practices among students participating in this assembly.MethodsThis study will take place at a French university (University Sorbonne Paris Nord, USPN) located in socio-economically disadvantaged suburbs of Paris. The student citizens’ assembly will gather a mini-public of 30 students enrolled at the time of the study and a co-creation team of academic and non-academic partners involved in student life, nutrition, physical activity, or public policies. The aim of the assembly is to co-create a set of concrete proposals that would enhance USPN students’ access to sustainable diets and physical activity. The protocol is based on a continuous process evaluation and a pre-post design among the mini-public. A mixed-method framework combining quantitative and qualitative approaches will be developed. This study will make use of (i) field observations of the intervention process and transferability, (ii) data collected by questionnaires on pre- and post- dietary habits, knowledge and citizen practices of the mini-public, and (iii) pre-post interviews with a subsample of the same mini-public.DiscussionRelying on participatory research methods, this study will provide new insights into involving higher education students and diverse partners in co-creating campus nutrition interventions. Through the collaborative work of researchers, higher education students, university representatives, public institutions, and local and community actors, this study will provide evidence-based guidance for designing innovative and contextually-relevant nutrition interventions in the higher education setting.Trial registrationThis research was registered at the ClinicalTrial.gov (NCT06580795; registration date: 2024–08-30; https://www.clinicaltrials.gov/study/NCT06580795).

Government procurement interventions as an economic and legal instrument to ensure a balance of interests of agricultural market participants

The sustainability of the agricultural sector of the economy is traditionally associated with a set of government support measures, among which public procurement interventions occupy a significant place. The article focuses on the importance of government procurement interventions for price regulation in the agricultural products market, which helps to ensure a balance of interests of its participants.The mechanism of public procurement transactions is considered, the problems of legal regulation are identified, including the lack of transparency in the selection of a procurement agent to the state intervention fund, the lack of a regulatory period for the start of public procurement transactions, and the difficulty of access to stock trading. Proposals have been formulated to improve the legal regulation of this sphere of relations.

Self-control failures, as judged by themselves

AbstractThe existence of self-control failures is often used to legitimize public policy interventions. The argument is that reducing self-control failures can make people better off, as judged by themselves. However, there is only scarce evidence on the frequency and welfare costs of self-control failures. This paper presents a survey method that allows us to measure self-control failures in everyday life and to identify their welfare costs in terms of associations with experienced subjective well-being. We present novel survey evidence using this method and discuss its implications for behavioural welfare economics and behavioural public policy.

Państwo wobec kryzysu mieszkaniowego. Dylematy polityki mieszkaniowej

The article aims to outline the framework and the fundamental approaches to housing policy. The author formulates fundamental questions (with possible answers) concerning public intervention in the housing sphere, i.e. about its permissible scope and manner and the entity that should be entitled to intervene. He also discusses the issue from the perspective of constitutional norms and the public policy cycle.

Analysing the Social Economy Business Survey Index (S-BSI): Development, Features, and Effectiveness in Social Economy Policymaking and Evaluation

This study delves into the Social Economy Business Survey Index (S-BSI), a tool designed to monitor the social and economic value generated within the social economy (SE) to furnish vital insights for timely public policy interventions. The study aims to comprehensively analyze the S-BSI, encompassing its development, distinctive features, and effectiveness as an advanced instrument for policymaking and evaluating the SE policy. The research methodology comprises an in-depth analysis of the S-BSI's development process, followed by multiple comparative analyses of similar surveys on a domestic and international scale. Furthermore, the study utilizes qualitative evaluation techniques grounded in the next-generation public policy framework for the SE sector. This multifaceted research approach aims to offer a holistic understanding of the S-BSI, delivering valuable insights tailored for policymakers and stakeholders engaged in shaping public policies for the SE.

Who is consuming ultra-processed food in Canada? A cross-sectional analysis of the 2018/2019 International Food Policy Study.

High consumption of ultra-processed foods and drinks (UPF) has been linked to poor diet quality and an increased risk of non-communicable diseases. To inform public policies and interventions aimed at reducing UPF intake in Canada, updated information on UPF intake among different sociodemographic groups is needed. This study, using data from 5,872 adults aged 18 years and older from the International Food Policy Study (2018-2019), aims to estimate the dietary energy contribution of UPF and assess its variation among sociodemographic subgroups. All foods and drinks reported in a single 24-hour dietary recall were classified using the Nova system. We estimated the mean proportion of total daily energy from UPF and subcategories of UPF in the overall sample and among sociodemographic subgroups. Multivariable linear regression models evaluated the association between sociodemographic characteristics with the proportion of total daily energy from UPF. On average, adults consumed 45.2% of their total daily energy from UPF. UPF consumption was slightly higher among males than females (49.4% vs. 47.6%, p=0.039) and younger adults aged 19-30 years compared with older adults aged 51-64 years (50.0% vs. 47.2%, p=0.029), adjusting for a range of sociodemographic factors. Overall, UPF consumption was relatively high among adults in all sociodemographic subgroups, highlighting the need for policies to decrease UPF consumption in the entire population.

THE PREVALENCE OF SOCIAL DISRESPECT TOWARDS CAREGIVERS: A BARRIER TO INDUSTRY GROWTH AND QUALITY ELDERLY CARE IN BANGLADESH

This study systematically reviews the issue of social disrespect towards caregivers in Bangladesh and its far-reaching implications for the caregiving profession and the quality of elderly care. Drawing from 80 high-quality studies, the review reveals that social disrespect—manifesting as verbal abuse, condescension, and lack of recognition—is a widespread problem faced by caregivers, leading to emotional exhaustion, burnout, and high turnover rates. The findings show that 65% of the studies reported frequent disrespect towards caregivers, while 72% established a direct link between this disrespect and increased burnout. Additionally, 68% of the studies indicated that social respect strongly correlates with job satisfaction, with higher levels of respect leading to improved caregiver morale, retention, and care quality. Institutional challenges, such as the absence of formal training and professional development opportunities, exacerbate this problem by reinforcing the perception that caregiving is low-status, unskilled labor. The review highlights the potential for public awareness campaigns, policy interventions, and institutional reforms to address these issues, recommending that Bangladesh adopt similar approaches to those successfully implemented in countries like Japan and Australia. By improving societal attitudes, professionalizing the caregiving industry, and providing mental health support, these measures could significantly enhance the social standing of caregivers, improve job satisfaction, and ultimately lead to better care outcomes for the elderly population.