Public Policy Research Articles

Community-Based Drug Recovery Program Social Services in Disruptive Times: Experiences of Person Who Use Drugs in Palawan, Philippines

The restricted movements during the COVID-19 pandemic have created challenges for people who use drugs (PWUDs) to access and complete community-based drug rehabilitation program (CBDRP) social services. This study aims to investigate the experiences of PWUDs undergoing CBDRP in Palawan, Philippines during disruptive times such as the COVID-19 pandemic with a focus on the changes in the social service support mechanisms enabling PWUDs to continue in their recovery. 188 PWUDs undergoing CBDRP in the 11 municipalities of Palawan participated in focus group discussions between July to December 2022. Participants were asked about the effects of the consequences of the COVID-19 pandemic such as social isolation; modification in the CBDRP social services delivery and accessibility; shifting focus of the CBDRP in-charge officers; and changing family dynamics. Transcripts were analyzed using thematic analysis and it revealed four themes: (1) Experiences of PWUDs on CBDRP social services support mechanisms as against as planned; (2) Challenges in completing CBDRP; (3) Leadership initiatives observed by PWUD; and (4) Role of local groups and PWUDs’ family in the recovery of PWUDs during COVID 19 pandemic. The study demonstrates a need for a holistic care approach with psychosocial needs support services; enhanced family and community engagement; sustainable livelihoods programs; digital transformation and digital engagement; and capacitating the social service providers particularly those at the barangay level and local groups as vital factors for better CBDRP delivery. Further, the study exposed the necessity for data-driven and context-specific policies flexible and agile enough to enable better social services delivery, community participation, and effective implementation. Keywords: community-based drug program, social services, person who uses drugs, COVID-19, public policy

How to measure Entrepreneurial Ecosystems? Current debate and challenges for the Brazilian case

Objective: The paper reviews and systematizes the metrics proposed in the literature for measuring the different elements of entrepreneurship ecosystems and discuss the challenges of measuring ecosystems at the regional level and in the Brazilian case. Method: Bibliographic review of the metrics proposed for Entrepreneurship Ecosystems and descriptive statistics to systematize the indicators found in the literature. Results: There is still no uniformity in the proposal of metrics. Most of them have a national approach and are related to the dimensions of public policy and regulation, culture, and resources. The effort to apply theory to the Brazilian case is still incipient, and it is necessary to construct adequate metrics for the national reality. Theoretical/methodological contributions: The article contributes to the debate on the measurement of entrepreneurship ecosystems by showing the diversity of proposed methodologies and indicators, existing gaps, the need to think about indicators for the subnational level, and the implications for the Brazilian case. Relevance/Originality: Despite its potential as a tool for public policies, the concept of EE and its measurement methods are still underexplored by the Brazilian academic community. The article aims to fill this gap and demonstrate that this line of academic research is promising.

The Role of Zakat in Automatic Equilibrium in the Islamic Economy Using the input-output Model

The study aimed to elucidate the role of Zakat in contributing to achieving automatic equilibrium in the economy quantitatively through the use of the input-output model. The study relied on a descriptive approach involving the analysis of quantitative data relevant to the discussion. The study addressed the effectiveness and efficiency of financial instruments of public policy and their role in contributing to achieving automatic equilibrium in both traditional and Islamic economies.
 The study concluded that Zakat has an impact on increasing total demand as measured quantitatively using the input-output model, which works to establish automatic equilibrium in the economy. The study recommended the inclusion of Zakat as a financial tool utilized by the state in its public policies to achieve its economic and social objectives, ensuring the attainment of economic equilibrium. Additionally, it suggested the possibility of employing quantitative methods and mathematical models to study the behavior of economic variables in the Islamic economy.

Mission-oriented scenarios: a new method for urban foresight

PurposeThe purpose of this study is to propose an innovative and efficient process in urban policy-making that combines a divergent and creative method with a convergent and strategic one. At the same time, the purpose is also to propose a useful innovation to enforce the usability of both methods. On the one hand, mission-oriented policies run the risk of being overly focused on the present and of not being able to develop preparedness in organization. On the other hand, scenario development has the reverse problem it often does not point out how to use scenario narratives to inform and devise short-term strategic actions.Design/methodology/approachThe paper proposes an innovative methodological approach, the mission-oriented scenarios, which hybridizes Mazzucato's mission-oriented public policy framework with Jim Dator's Manoa school four futures method. The proposed methodological innovation emerges from a urban foresight academic-led project carried out in the context of the Metropolitan City of Turin, Italy, where a first application of the mission-oriented scenarios was tested on six different focal issues (from reindustrialization to cultural policies) and the scenario narratives were used as sources for the grounding of 12 missions and 48 strategic actions towards 2030.FindingsMission-oriented scenarios can contribute to the generation of more sustainable and inclusive urban public policies. This methodological proposal is based on an original mix of knowledge exchange procedures borrowed from methodological approaches with different backgrounds: the mission-oriented and the archetypal scenarios. Their conjunction could support the formulation of ambitious yet pragmatic policies, giving a plurality of actors the opportunity to act and establish fruitful and lasting partnerships.Originality/valueThe paper reconstructs one of the first urban foresight projects carried out in a major Italian city by two prestigious universities and exposes a methodological innovation resulting from reflection on the strengths and weaknesses of the project, which opens the door to the development of a new scenario technique.

Public Reason, Bioethics, and Public Policy: A Seductive Delusion or Ambitious Aspiration?

Can Rawlsian public reason sufficiently justify public policies that regulate or restrain controversial medical and technological interventions in bioethics (and the broader social world), such as abortion, physician aid-in-dying, CRISPER-cas9 gene editing of embryos, surrogate mothers, pre-implantation genetic diagnosis of eight-cell embryos, and so on? The first part of this essay briefly explicates the central concepts that define Rawlsian political liberalism. The latter half of this essay then demonstrates how a commitment to Rawlsian public reason can ameliorate (not completely resolve) many of the policy disagreements related to bioethically controversial medical interventions today. The goal of public reason is to reduce the size of the disagreement by eliminating features of the disagreement that violate the norms of public reason. The norms of public reason are those norms that are politically necessary to preserve the liberal, pluralistic, democratic character of this society. What remains is reasonable disagreement to be addressed through normal democratic deliberative processes. Specific issues addressed from a public reason perspective include personal responsibility for excessive health costs, the utility of a metaphysical definition of death for organ transplantation, and the moral status of excess embryos generated through IVF and/or their use in medical research.

Biomarker Assessment of Nicotine Exposure Among Adolescent E-Cigarette Users: 2018-2019.

Despite the increasing prevalence of vaping e-cigarettes among adolescents, there remains a lack of population-level assessments regarding the objective measurement of nicotine exposure. This study analyzed a nationally representative sample of adolescents aged 13 to 17 years from Wave 5 of the Population Assessment of Tobacco and Health Study conducted between 2018 and 2019. Urinary nicotine metabolites, including cotinine and trans-3'-hydroxycotinine (3-HC), were assessed among exclusive nonnicotine e-cigarette users (n = 56), exclusive nicotine e-cigarette users (n = 200), and nonusers (n = 1059). We further examined nicotine exposure by past 30-day vaping frequency (ie, occasional [1-5 days], intermittent [6-19 days], and frequent [20+ days]) and flavor types among nicotine e-cigarette users. Multivariable linear regressions tested pairwise group effects, and biomarkers were normalized by the log transformation. Compared with nonusers, both nonnicotine and nicotine e-cigarette users exhibited higher levels of cotinine and 3-HC. Nicotine e-cigarette users had mean cotinine concentrations (61.3; 95% confidence interval, 23.8-158.0, ng/mg creatinine) approximately 146 times higher (P < .0001) than nonusers (0.4; 0.3-0.5), whereas nonnicotine users (4.9; 1.0-23.2) exhibited cotinine concentrations ∼12 times higher (P = .02). Among nicotine e-cigarette users, the levels of cotinine and 3-HC increased by vaping frequency, with cotinine increasing from 10.1 (2.5-40.1) among occasional users to 73.6 (31.8-170.6) among intermittent users and 949.1 (482.5-1866.9) among frequent users. Nicotine exposure was not significantly different by flavor type. E-cigarette use poses health-related risks resulting from nicotine exposure among adolescents. Comprehensive regulations of e-cigarette products and marketing, vaping prevention, cessation, and public policies are needed to prevent youth from developing nicotine addiction.

ISO 37120 Indicators for Sustainable Cities: Brazil and Portugal

Purpose: the main goal of the research is to analyze the ISO 37120 indicators in two cities located in Brazil and Portugal, verifying whether sustainable development strategies are present in public policies. Design: This research fits in a quantitative methodology, making use of on-line survey. The units of analysis of this research are the municipalities of Guarapuava - Brazil and Matosinhos – Portugal, Cross-Country Comparative Research. Findings: Through quantitative research, the citizens have presented a general perception about Education, Health, and Security indicators, sometimes in a positiveway, other times in a negative one. About the main objective, it was noticed that the the connection between the inquired citizens were the related indicators (sectors). The results obtained show that the ISO 37120 indicators can assist in an integrated monitoring of city governance, and function as advisory tool for some specific goals to city improvement in many aspects. Research implications: The research applied ISO indicators, which are very powerful to evaluate the public policies of cities. Therefore, it contributed with a potential evaluative instrument that indicates the priority targets for investments and development of public actions. Given that, the research also developed important reflections that may benefit the governance and provision of effective public services in many areas, namely, decision making support, urban planning and cities master plans, and UN SDG 11.

EDUCATION IN DIVERSITY

Introduction: Students with special educational needs are included in the perspective of inclusive education, which, in recent years, has gained prominence and has been widely discussed Objective: to carry out a survey of some works from the last 6 years that cover the theme of Education and teaching pedagogical practice in the proposal for inclusive education Methodology: This is a descriptive literature review with qualitative characteristics in the Scielo and Google Scholar databases in articles published, in Portuguese, between 2015 and 2021. Conclusions: It is possible to conclude Although educating in diversity is possible, as long as public policies are actually implemented, teacher training requires more investment and attention from schools.

An Analysis of Female Empowerment and Its Role in Mitigating Intimate Partner Violence in Ecuador

ABSTRACT This research article aims to analyze the effect of female empowerment on gender-based intimate partner violence against women in Ecuador, a country where levels of violence stand out in the region. We apply an instrumental variable regression model using official data from the 2019 National Survey on Family Relations and Gender Violence against Women. We found a negative association between women empowerment and intimate partner violence, that is, greater empowerment of women is associated with lower manifestations of intimate partner violence. We also find a positive reverse association between manifestations of intimate partner violence against women and empowerment. This means that a woman who has been a victim of intimate partner violence will be more willing to embrace ideals that empower women. From a public policy perspective, government engagement with promotion of female empowerment will reduce intimate partner violence against women and the costs associated with it.

Assessment of The Efficiency of The Territorial Administrative Reorganization of The Parishes of The District of Braga

Purpose: The objective of this study was to identify whether the reorganization of parishes carried out in Portugal, in the District of Braga, in 2013, is the one that enhances the greatest efficiency gains. Theoretical framework: The study is based on the relationship between financial sustainability, efficiency, and territory, seeking the optimal dimension of the local power unit. Methodology: The study is based on the Data Envelopment Analysis method, using data from the parishes of the district of Braga in two moments, the year 2012 and the year 2015. For this year, a new territorial reorganization was also proposed and analysed. Results and Conclusions: The reform increased efficiency in 10 of the 14 municipalities. However, it was possible to observe that a reorganization that gives the parishes a larger size, that is, closer to the average seen in the European Union, would bring average efficiency gains in all municipalities. Thus, it is concluded that the reform of the parishes carried out in 2013 in the district of Braga is not the one that allows greater efficiency, since this can be enhanced if they benefit from a larger geographical scale. Research implications: The research contributes to the knowledge of the efficiency of territorial reforms, namely, regarding the impact of the dimension in this context, as well as to the evaluation of the public policy adopted, allowing the public decision-maker to make a sound and sustained decision. Originality/value: This study is original because it studies smaller units of local government, the parishes, on which research is very incipient, namely in Portugal.

Young people's alcohol use in and around water: A scoping review of the literature.

The surrounding social and commercial context, including alcohol advertising, heavily influences alcohol consumption. Alcohol use is a major risk factor for both fatal and non-fatal drowning, particularly for young people. We conducted a scoping review to explore the peer-reviewed literature on the use of alcohol by young people (aged 15-34 years) in the context of aquatic environments. Five electronic academic databases were searched for English-language studies conducted in high-income countries and published in the last 15 years (since 2008). The MetaQAT framework was used to assess methodological quality of included studies. The review included a total of 24 studies, including those addressing the prevalence of and/or risk factors for alcohol use in aquatic environments among young people (n = 13); the epidemiology of alcohol-related unintentional drowning in young people (n = 9); and interventions to reduce alcohol-related harm around water (n = 3). Findings suggest that young people commonly consume alcohol around water, particularly young men. We found multiple influences on this behaviour, including the perception of risk, location of aquatic activity and presence of others, particularly peers. Understanding the literature addressing alcohol use around water among young people will assist in identifying and setting priorities for drowning prevention, including the need to mitigate the effects of alcohol advertising which promotes drinking in and around water. There is a clear imperative to address the use of alcohol by young people in aquatic environments. These findings have key implications for public health policy, advocacy and practice.

Zero Waste household practices in informal settlements: an opportunity to improve the living conditions of the urban poor and address global challenges

Zero Waste household practices adopted in informal settlements have facilitated the reduction of greenhouse gas emissions and contributed to income generation, food security and the strengthening of the social fabric. In four informal settlements in Santiago de Cali (Colombia), these practices were identified through participatory methodologies, and statistical tests of association between variables were used to determine possible causes of their implementation. These practices were found to be associated with characteristics of the residents including their connection to the cultural traditions of their places of origin, their resilience and solidarity, the satisfaction of their basic needs and their search for a healthy environment. This paper discusses these practices, the elements that drive them and their main benefits, highlighting the need for public policies to recognize their contributions in addressing global challenges and for future research to quantify their contributions.

Promoting policy evaluation across government: The contribution of the OECD recommendation to public policy evaluation

Policy evaluation is now recognised by many governments as fundamental to ensuring that policies are informed by quality evidence. Nevertheless, the practice of policy evaluation is still difficult to systematise inside governments. Building on more than 20 years of work on this topic, the Organisation for Economic Co-operation and Development Recommendation on Public Policy Evaluation, adopted in 2022, represents the first international legal guidance on the topic. It identifies three essential pillars to ensure the impact of policy evaluation: institutionalisation, quality and use. This article explains how the Organisation for Economic Co-operation and Development Recommendation was developed, what these three pillars cover, and reflect on how the Organisation for Economic Co-operation and Development can further help countries developing a sound evaluation system.

Endemic does not mean constant as SARS-CoV-2 continues to evolve.

COVID-19 has become endemic, with dynamics that reflect the waning of immunity and re-exposure, by contrast to the epidemic phase driven by exposure in immunologically naïve populations. Endemic does not, however, mean constant. Further evolution of SARS-CoV-2, as well as changes in behavior and public health policy, continue to play a major role in the endemic load of disease and mortality. In this article, we analyze evolutionary models to explore the impact that a newly arising variant can have on the short-term and longer-term endemic load, characterizing how these impacts depend on the transmission and immunological properties of the variants. We describe how evolutionary changes in the virus will increase the endemic load most for a persistently immune-escape variant, by an intermediate amount for a more transmissible variant, and least for a transiently immune-escape variant. Balancing the tendency for evolution to favor variants that increase the endemic load, we explore the impact of vaccination strategies and non-pharmaceutical interventions that can counter these increases in the impact of disease. We end with some open questions about the future of COVID-19 as an endemic disease.

Exposure to armed conflict and monitoring as predictors of aggression in a population immersed in a long‐term conflict

AbstractAs armed conflict can influence social behavior, exposed individuals would experience modulated executive functioning, crucial to regulating aggressive responses. Since it is still unclear whether there is an association, this study examines the relationship between performance in executive functions and expression of reactive and proactive aggression, measured using the Reacting Proactive Aggression Questionnaire. The sample includes 128 civilians and ex‐combatants with different levels of exposure to the Colombian armed conflict. The study found that reactive aggression was directly linked to conflict exposure and was also influenced by age and monitoring ability. This suggests that an updated working memory and age play a role in reactive aggression. In contrast, proactive aggression was directly linked to conflict exposure but not to specific executive functions. In conclusion, individuals with less monitoring who live in high‐conflict regions present an increased likelihood of reactive aggression. Additionally, reasonable executive control of thoughts and actions, which involves updating past experiences, appears to be crucial in social contexts, especially violent ones. These findings shall inform interventions and public policies that address the psychosocial risks of aggressive behaviors.

Are Land Use and Cover Changes and Socioeconomic Factors Associated with the Occurrence of Dengue Fever? A Case Study in Minas Gerais State, Brazil

Several studies have already demonstrated the relationship between the loss of natural habitats and the incidence of diseases caused by vectors, such as dengue, which is an acute fever disease that is considered a serious public health problem. The aim of the present study was to investigate the relationship between the number of dengue cases and land use and cover changes (LUCC) and socioeconomic and climatic factors by municipality, using the state of Minas Gerais as a case study. For this, secondary data obtained from openly available sources were used. Natural vegetation cover data were obtained from the MAPBiomas platform and dengue occurrence data from the Ministry of Health, in addition to eight socioeconomic parameters from the Brazilian Institute for Geography and Statistics and precipitation data from the Brazilian Agricultural Research Corporation (EMBRAPA, Sete Lagoas, Minas Gerais). Between 2015 and 2019, 1,255,731 cases of dengue were recorded throughout the state of Minas Gerais, ranging from 0 to 227 per thousand inhabitants between municipalities. The occurrence of dengue was distributed throughout all regions of Minas Gerais and was associated with LUCC and socioeconomic factors. In general, municipalities with a net loss of natural vegetation, predominantly located in the Cerrado biome, had the highest number of dengue cases in the studied period. Additionally, the occurrence of dengue was associated to three socioeconomic parameters: population density, human development index (both positively), and Gini inequality index (negatively). These results indicate that, contrary to expectations, municipalities with better social conditions had more dengue cases. Our study indicates that natural vegetation is, directly or indirectly, involved in the ecosystem service of dengue control, despite the occurrence of this disease being affected by multiple factors that interact in a complex way. Thus, policies towards reducing deforestation must be complemented by a continuous investment in public health policies and a reduction in social inequalities to efficiently control dengue fever.

Folic Acid–Fortified Iodized Salt and Serum Folate Levels in Reproductive-Aged Women of Rural India

India has a disproportionately high prevalence of neural tube defects, including spina bifida and anencephaly (SBA), causing a high number of stillbirths, elective pregnancy terminations, and child mortality; India contributes a large proportion of the global burden of SBA. Thirty years after folic acid was shown to be effective in reducing SBA prevalence, only about one-quarter of such births are prevented globally through cereal grain fortification. To determine the association of folic acid-fortified iodized salt with serum folate concentrations among nonpregnant and nonlactating women of reproductive age. This nonrandomized controlled trial using a preintervention and postintervention design was conducted in 4 rural villages in Southern India from July 1 to November 30, 2022. All households in the villages agreed to participate in the study. Preintervention and postintervention serum folate levels were analyzed among study participants at baseline and after 4 months, respectively. Consumption of approximately 300 µg/d of folic acid using double fortified salt (folic acid plus iodine). Median serum folate concentrations were assessed at baseline and 4 months. Change in median serum folate levels between baseline and study end point as the primary outcome of the study. A total of 83 nonpregnant nonlactating women aged 20 to 44 years (mean [SD] age, 30.9 [5.1] years) were eligible for the study and provided serum samples for analysis at baseline and the end point of the intervention. The median serum folate concentration increased from 14.6 (IQR, 11.2-20.6) nmol/L at baseline to 54.4 (IQR, 43.5-54.4) nmol/L at end of study, a 3.7-fold increase from baseline to study end point. Two-tailed Wilcoxon signed rank test showed the median difference in preintervention and postintervention serum folate concentrations to be highly significant (P < .001). The participants found the salt acceptable in color and taste. Use of folic acid-fortified iodized salt was associated with increased serum folate concentrations in women of reproductive age. This novel evidence can inform public health policy to accelerate SBA prevention. ClinicalTrials.gov Identifier: NCT06174883.

Hospitalisation for herpes zoster in people with and without diabetes: A 10-year-observational study

AimsThis study explores the association between Herpes Zoster (HZ) hospitalizations and diabetes in Piedmont, Italy from 2010 to 2019. Focusing on the burden of HZ hospitalizations in diabetic and non-diabetic groups, it aims to identify risk factors in diabetics to enhance prevention strategies. MethodsIn a two-phase study, we first compared age-standardized HZ hospitalization rates between diabetic and non-diabetic individuals from 2010 to 2019. We then examined hospitalization risk factors for HZ within a diabetic patient cohort managed by regional diabetes clinics. ResultsOf 3,423 HZ hospitalizations in 2010–2019, 17.9 % (613 cases) were diabetic patients, who exhibited higher hospitalization rates (15.9 to 6.0 per 100,000) compared to non-diabetese individuals. Among diabetics subjects risk factors for HZ hospitalization included age over 65, obesity (BMI > 30), and poor glycemic control (HbA1c > 8.0 %). These patients had a 40 % increased rehospitalization risk and a 25 % higher risk of severe complications, such as stroke and myocardial infarction, post-HZ. ConclusionsDiabetes markedly increases HZ hospitalization rates, rehospitalization, and complication risks. These findings underscore the need for preventive strategies, especially improved glycemic control among high-risk diabetic patients, to inform public health policies and clinical practices aimed at mitigating HZ's impact on this population.

Debt Bondage and Seasonal Migration: A Study of Western Odisha, India

The purpose of the study is to investigate the causes of distressed migration in western Odisha, India, as well as how the economic system is affected by debt bondage. It studies the causes of the seasonal migration of debt bondage utilising the survey. The data are analysed using a binary choice model, and the results suggest that seasonal migrants are more likely to come from impoverished, socially disadvantaged, less educated, indebted and landless households. It suggests the identification of forward and backward linkages between diverse economic activity as well as the creation of job opportunities while deciding on public policy for this region.

Multicultural-Based Public Policy: The Experience of Indonesia in Managing Diversity for National Resilience

The management of societal diversity through multicultural-based public policies is an interesting issue that is developing in the democratic system of the Indonesian nation today. This research aims to analyze multicultural-based public policy in three elements such as managing diversity, democratic politics, and national identity in strengthening Indonesia's national resilience. Through a study of the intertextuality of documents on multicultural issues, this research analyzes library data related to the policy concepts, regulations, and responses of society to the practice of multicultural policies in the public sector. The findings of this research describe several multicultural policies that are difficult to implement in the democratic political system of Indonesia. It often deals with identity politics based on religion. To strengthen national identity, the Indonesian government applies two essential philosophies in all aspects of national life, namely Pancasila and Bhineka Tunggal Ika. Both contain strong multicultural values as the historical heritage of the Indonesian society which are continuously maintained through the policy of establishing the Pancasila Ideology Development Agency (BPIP). Multicultural-based public policies have strengthened national identity, nationalism attitude, social integration of society that supports the resilience of the Indonesian nation for unity in its diversity to date