Scope For Impact Research Articles

Climate change mitigation policy for planetary health equity? An automated content analysis of countries’ nationally determined contribution reports

Abstract Introduction This study examines the extent to which national governments discuss the social determinants of planetary health equity (SDPHE) within their Nationally Determined Contribution reports (NDCs) to the UN Framework Convention on Climate Change. This is assessed relative to the frequency of discussion of economic factors and health outcomes, and how this varies between countries based on political, economic, and environmental factors.
Methods Using natural language processing, a dictionary-based automated content analysis was conducted of the frequency of terms within these reports. Correlation analyses examined the relationship between the frequency of dictionary categories and political, economic, and environmental variables to ascertain the role of contextual factors.
Results Overall, NDCs were found to feature a greater proportion of economic language compared to health outcome and SDPHE terms. Among the SDPHE, equity- and gender-related terms occurred most frequently. Correlations were identified primarily among high-income countries, that suggest moderate positive associations between levels of CO2 emissions per capita and per dollar of GDP and the use of economic terms, and a negative association of economic language with levels of democracy. Democracy was also positively associated with language related to social norms such as equity and justice, indicating potential scope for impact through democratic pressures.
Conclusion The relatively frequent use of economic frames in NDCs suggests that economic issues may receive more attention compared to the SDPHE. This analysis identifies potential enabling and constraining country-level factors for greater attention to the SDPHE in NDCs and more progressive climate change mitigation policymaking.

See no Evil, Hear no Evil, Speak no Evil: The grey literature and Australia's failure to address change in the National Disability Insurance Scheme

AbstractThe National Disability Insurance Scheme (NDIS) represents a social reform of a magnitude unseen in Australia. The Scheme's significant scope for impact warrants that proper performance evaluation is undertaken, that stakeholder interactions are collaborative and that the scheme is outcome driven. This article reviews a selection of grey literature to gain insights into the persistence of challenges facing the Scheme, as well as how the policy discourse has developed between 2011 and 2020. Our review finds that key issues related to the Scheme's effectiveness and sustainability have been persistent and repeatedly documented by stakeholders. Furthermore, we find that, had the grey literature been heeded, the current and predictable challenges facing the NDIS could have been mitigated at least to some extent. Our contribution here is to renew scholarly vigour toward the Scheme by canvassing its challenges as identified by commentators, policymakers and the industry itself and to focus attention on the capacity for this literature to predict and describe potential and extant problems as well as providing mitigations. By extension, we provide a catalogue of these challenges while showcasing the value of grey literature as one source of triangulating evidence in informing policy evaluation.

The Impact of Transition Intervention in High School on Pathways Through College

Objective: In 2009, the Kentucky General Assembly found unacceptable and costly the ongoing high numbers of high school students requiring remediation once they enter higher education. The state passed legislation to better align secondary and college education, establishing a diagnostic cycle that would become its Targeted Interventions (TI) program. Using 11 years of panel data, this study tracked college progression of seven cohorts of students in order to estimate the impacts of this program. Method: Using student-level administrative data from the state of Kentucky that tracks students from high school through college, a difference-in-regression-discontinuity design was used to compare how students just below college readiness benchmarks fared relative to those just above once TI was implemented. Results: The TI program significantly increased the likelihood that students took at least 15 credits during their first term, a key predictive measure for college completion. However, these early effects did not translate into detectable impacts on the likelihood of earning enough credits to graduate from college or likelihood of transfers from a 2-year to a 4-year college. One possible explanation for this pattern is that TI appears to have crowded out other core courses in high school, especially in math, without increasing total instructional time. Findings suggest that the standards used by high schools to judge student progress toward college readiness may be consistent with the skills needed to place out of developmental courses, but not sufficient to better prepare students for college-level instruction. Contributions: To our knowledge, this is the first study to explore how TI shapes longer term college outcomes. The transition curriculum, while helping students avoid the need for college developmental courses, did not help a measurable share of students develop necessary skills to progress through college relative to what they would have otherwise taken. A possible explanation for these findings is that high school-to-college transition interventions that do not increase total instruction time do not sufficiently move the needle on the college preparedness among high school graduates. For states concerned with the number of students entering college deemed not college ready, it appears that high school-to-college transition interventions that supplant instead of supplement regular high school curriculum have a limited scope for impact on long-run college success.

Impact of home garden interventions in East Africa: Results of three randomized controlled trials

Sub-Saharan Africa has the lowest per capita consumption of vegetables of all regions in the world. As low vegetable consumption is associated with poor human health, there is need for effective policies and interventions to increase it. Home garden interventions have proven effective in several countries in Asia, but evidence from large trials is scant in Africa. Using data from a home garden promotion project in Kenya, Tanzania and Uganda, this study tests the hypothesis that home garden interventions, offered to rural households with women 14–35 years of age and/or with children under five years of age, increase household production and consumption of vegetables. Three randomized controlled trials collected pre- and post-intervention data (2 years apart) for 1,255 intervention and control households. We report intent-to-treat effects and the treatment effect on the treated and analyze distributional effects using quantile regression. For Tanzania, the results show a 20% increase in households producing vegetables and an additional two months of vegetable harvesting, but no such significant effects were found for Kenya and Uganda. We find no significant effects on diets. Lack of impact may be explained from the fact that many participating households were already producing vegetables (reducing the scope for impact) and a low participation rate of selected households in training events. These results stand in contrast to the positive impacts of home garden interventions in Asia. The results suggest a need to better understand barriers to home garden interventions in the three countries and a need for more careful design, local adaptation and targeting.

The benefits of very low earth orbit for earth observation missions

Very low Earth orbits (VLEO), typically classified as orbits below approximately 450 km in altitude, have the potential to provide significant benefits to spacecraft over those that operate in higher altitude orbits. This paper provides a comprehensive review and analysis of these benefits to spacecraft operations in VLEO, with parametric investigation of those which apply specifically to Earth observation missions. The most significant benefit for optical imaging systems is that a reduction in orbital altitude improves spatial resolution for a similar payload specification. Alternatively mass and volume savings can be made whilst maintaining a given performance. Similarly, for radar and lidar systems, the signal-to-noise ratio can be improved. Additional benefits include improved geospatial position accuracy, improvements in communications link-budgets, and greater launch vehicle insertion capability. The collision risk with orbital debris and radiation environment can be shown to be improved in lower altitude orbits, whilst compliance with IADC guidelines for spacecraft post-mission lifetime and deorbit is also assisted. Finally, VLEO offers opportunities to exploit novel atmosphere-breathing electric propulsion systems and aerodynamic attitude and orbit control methods.However, key challenges associated with our understanding of the lower thermosphere, aerodynamic drag, the requirement to provide a meaningful orbital lifetime whilst minimising spacecraft mass and complexity, and atomic oxygen erosion still require further research. Given the scope for significant commercial, societal, and environmental impact which can be realised with higher performing Earth observation platforms, renewed research efforts to address the challenges associated with VLEO operations are required.

The psychological impact of early pregnancy loss.

Early pregnancy loss (EPL) is a common event, with scope for long-term personal and societal impact. There are three decades worth of published evidence of profound psychological sequelae in a significant proportion of women. However, the wide variety of outcomes, screening instruments, assessment timings and geographical locations makes it challenging to form a coherent picture of the morbidity within the whole group and its subgroups. This review aims to investigate three questions. (1) What is the evidence for depression, anxiety and post-traumatic stress disorder (PTSD) following a miscarriage or an ectopic pregnancy in women and/or their partners? (2) What is the intensity and duration of these conditions, and how do they compare to those without losses? (3) Which patients have been found to be at highest risk of psychopathology? Answers to these questions are salient not only in day-to-day clinical interactions with those experiencing EPL, whose psychological needs may not be prioritized, but should also form the basis for tailoring healthcare policy in terms of screening for and treating the associated psychological morbidity. The following databases were searched, from the start of each database up to July 2017: MEDLINE (Ovid interface, 1948 onwards), Embase classic + Embase (Ovid interface, 1947 onwards), and PsychINFO (Ovid interface, 1806 onwards). Search strategies were developed using medical subject headings (MeSH). The concepts of psychological morbidity (anxiety, depression or PTSD) and pregnancy loss (miscarriage or ectopic pregnancy) were first expanded with the Boolean operator 'or', then linked together using 'and'. Included studies were of prospective cohort design, including women or men following EPL (with the majority to have experienced losses before 24 weeks gestation), and reporting standardized psychometric measures for anxiety, depression and post-traumatic stress disorder. The timing of follow-up had to be specified and standardized across participants. Manuscript quality and risk of bias was assessed using the Newcastle-Ottawa Scale. We found evidence of significant depression and anxiety in the first month following EPL in women. Partners were also shown to display depression and anxiety, albeit to a generally lower level. There is also evidence of post-traumatic stress symptoms relating to the EPL in three studies. In view of their high frequency, EPLs can significantly contribute to the overall burden of psychopathology within a population. Recognition of this impact is important, so that severely affected individuals may be screened and treated appropriately. Further research to establish risk factors to promptly identify and treat these patients, and to optimize their management, is crucial.

Medialny obraz rzeczywistości

Prowadzone od dziesięcioleci badania empiryczne dowiodły jednoznacznie, że media oddziałują na swoich odbiorców. W zależności od dekady i obowiązującego paradygmatu wskazywano szerszy lub węższy zakres potencjalnego wpływu. Autor prezentuje wybrane wyniki badań nad procesem agenda­‑setting i uramowienia (framing) a także cech charakterystycznych obu zjawisk celem poszukiwania odpowiedzi na pytanie czy mechanizmy stojące za nimi powinny być rozpatrywane w kategorii manipulacji. Współcześnie, w dobie gwałtownego rozwoju „nowych” mediów, w szczególności platform społecznościowych, jednostki nie są już jedynie biernymi odbiorcami, ale mogą pełnić rolę aktywnego nadawcy. Powoduje to, że oddziaływanie mediów wydaje się być rozproszone. Celem niniejszego artykułu jest też próba odpowiedzi na pytanie, jaką rolę pełnią dziś tradycyjne media i czy ich rola w ustanawianiu agendy tematycznej uległa znaczącej zmianie.

Thermodynamic insights and assessment of the ‘circular economy’

This study analyses the effect on energy use of applying a wide range of circular economy approaches. By collating evidence on specific quantifiable approaches and then calculating and analyzing their combined full supply chain impacts through input-output analysis, it provides a more complete assessment of the overall potential scope for energy savings that these approaches might deliver than provided elsewhere. Assessment is conducted globally, across the EU-27 and in the UK.Overall, the identified opportunities have the potential to save 6%–11% of the energy used to support economic activity, worldwide and in the EU, and 5%–8% in the UK. Their potential is equivalent to the total scope for other industrial energy efficiency savings.The potential savings are further divided into those due to sets of approaches relating to food waste, steel production, other materials production, product refurbishment, vehicle provision, construction and other equipment manufacture. Each of these sets of approaches can make a key contribution to the total savings that are possible.Complementary use of energy and exergy metrics illustrates the way in which energy use might change and for the first time provides indication that in most cases other energy efficiency measures are unlikely to be adversely affected by the circular economy approaches.Potential for savings in the energy embodied in each key product input to each major sector is assessed, enabling prioritization of the areas in which the circular economy approaches have the greatest scope for impact and identification of supply chains for which they are underrepresented.

Carp–mola productivity and fish consumption in small-scale homestead aquaculture in Bangladesh

Small indigenous species (SIS) of fish such as the mola carplet (Amblypharyngodon mola) are rich in nutrients, often containing high levels of zinc, iron, and vitamin A. Despite scientific and government efforts, culture of SIS for improved nutrition is not yet widespread. This paper investigates the contribution of the mola carplet, commonly referred to in Bangladesh as “mola” to household fish consumption, and the factors influencing productivity and income from carp–mola polyculture in southwest Bangladesh. In addition, we assess the effect of inclusion of mola into carp polyculture ponds on the inputs required to culture fish in homestead ponds. Carp–mola polyculture farmers (n = 344) and carp-only polyculture farmers (n = 513, as controls) were surveyed in May 2013. Mola broodstock were stocked in 4881 homestead ponds, at an average rate of 25 kg ha−1. The results indicated that pond area, water color (a proxy of phytoplankton abundance) and inorganic fertilizer (primarily urea and TSP) significantly influence mola production. Smaller ponds proved to have higher productivity than larger ponds. Production and profitability of carp–mola polyculture system are significantly higher (P < 0.1) than carp-only polyculture systems. Mola also contributed to household fish consumption, with 47 % of mola produced in homestead ponds consumed by household members. The results suggest scope for wider dissemination and impact of mola production technology. Such dissemination might involve closer collaboration among research, governmental, and non-governmental organizations, involving lead farmer selection, farmer-to-farmer visits and result demonstrations and wider communication of the positive outcomes of culturing mola.

PrEP as a feature in the optimal landscape of combination HIV prevention in sub-Saharan Africa.

IntroductionThe new WHO guidelines recommend offering pre-exposure prophylaxis (PrEP) to people who are at substantial risk of HIV infection. However, where PrEP should be prioritised, and for which population groups, remains an open question. The HIV landscape in sub-Saharan Africa features limited prevention resources, multiple options for achieving cost saving, and epidemic heterogeneity. This paper examines what role PrEP should play in optimal prevention in this complex and dynamic landscape.MethodsWe use a model that was previously developed to capture subnational HIV transmission in sub-Saharan Africa. With this model, we can consider how prevention funds could be distributed across and within countries throughout sub-Saharan Africa to enable optimal HIV prevention (that is, avert the greatest number of infections for the lowest cost). Here, we focus on PrEP to elucidate where, and to whom, it would optimally be offered in portfolios of interventions (alongside voluntary medical male circumcision, treatment as prevention, and behaviour change communication). Over a range of continental expenditure levels, we use our model to explore prevention patterns that incorporate PrEP, exclude PrEP, or implement PrEP according to a fixed incidence threshold.ResultsAt low-to-moderate levels of total prevention expenditure, we find that the optimal intervention portfolios would include PrEP in only a few regions and primarily for female sex workers (FSW). Prioritisation of PrEP would expand with increasing total expenditure, such that the optimal prevention portfolios would offer PrEP in more subnational regions and increasingly for men who have sex with men (MSM) and the lower incidence general population. The marginal benefit of including PrEP among the available interventions increases with overall expenditure by up to 14% (relative to excluding PrEP). The minimum baseline incidence for the optimal offer of PrEP declines for all population groups as expenditure increases. We find that using a fixed incidence benchmark to guide PrEP decisions would incur considerable losses in impact (up to 7%) compared with an approach that uses PrEP more flexibly in light of prevailing budget conditions.ConclusionsOur findings suggest that, for an optimal distribution of prevention resources, choices of whether to implement PrEP in subnational regions should depend on the scope for impact of other possible interventions, local incidence in population groups, and total resources available. If prevention funding were to become restricted in the future, it may be suboptimal to use PrEP according to a fixed incidence benchmark, and other prevention modalities may be more cost-effective. In contrast, expansions in funding could permit PrEP to be used to its full potential in epidemiologically driven prevention portfolios and thereby enable a more cost-effective HIV response across Africa.

Whose voices? Patient and public involvement in clinical commissioning.

AimThis paper aims to explore patient and public representation in a NHS clinical commissioning group and how this is experienced by staff and lay members involved.BackgroundPatient and public involvement is believed to foster greater public representativeness in the development and delivery of health care services. However, there is widespread debate about what representation is or what it should be. Questions arise about the different constructions of representation and the representativeness of patients and the public in decision‐making structures and processes.DesignEthnographic, two‐phase study involving twenty‐four observations across two types of clinical commissioning group meetings with patient and public involvement, fourteen follow‐up interviews with NHS staff and lay members, and a focus group with five lay members.ResultsPerceptions of what constitutes legitimate representativeness varied between respondents, ranging from representing an individual patient experience to reaching large numbers of people. Consistent with previous studies, there was a lack of clarity about the role of lay members in the work of the clinical commissioning group.ConclusionsUnlike previous studies, it was lay members, not staff, who raised concerns about their representativeness and legitimacy. Although the clinical commissioning group provides resources to support patient and public involvement, there continues to be a lack of clarity about roles and scope for impact. Lay members are still some way from constituting a powerful voice at the table.

The Impact of the Spezzino Judgment for Third Sector Organisations

This paper analyses the potential implications that the Spezzino case may have for third sector organisations wishing to take part in the public procurement of certain service contracts. The Court of Justice of the EU (CJEU) held as admissible in Spezzino to award directly and on a preferential basis some service contracts to not-for profit organisations compliant with certain requirements. This decision by the CJEU constitutes a major derogation of the principles of Articles 49 (freedom of establishment) and 56 (freedom of services) of the TFEU. The paper is structured around the requirements established by CJEU in Spezzino, the impact it may have on third sector organisations across the EU and its relationship going forward with Directive 2014/24/EU, particularly the new “light touch regime” for specific categories of contracts. This paper argues that the scope for impact on third sector organisations is smaller than anticipated at first glance. The exception created by Spezzino only applies to contracts subject to primary EU law, that is contracts with a cross-border interest but not covered by either Directive 2004/18/EC or Directive 2014/24/EU. Furthermore, the grounds for the exception need to be interpreted restrictively. In consequence, going forward it is arguable that it only applies to all emergency ambulance service contracts, as these are explicitly excluded from Directive 2014/24/EU, and urgent ambulance service contracts with a value under €750,000 and a cross-border interest.

The essential role of music interlending: how it supports music making in the UK

PurposeThe purpose of this paper is to review the development and current state of music interlending in UK libraries, examining the materials themselves, their management challenges, range of users, cultural value, and scope for impact. It choses to highlight the interlending of performance materials (vocal scores and orchestral sets) as having particular cultural significance, being at the heart of music making in schools and the wider community and providing an element of value in people's lives through performance‐related activity.Design/methodology/approachFrom modest beginnings and tentative steps in library cooperation, the paper considers the development of regional and national catalogues culminating in the launch of the “Encore!” database, together with a brief discussion of other relevant topics such as copyright, the role of publishers and the physical constraints of the materials themselves.FindingsIn an attempt to quantify the growth and current level of music interlending traffic, the paper concludes that there has been considerable increase and that, if standard calculations are applied, music sets now account for perhaps the largest “volume” element of interlending for UK (public) libraries, contributing the sole area of growth in a largely declining field.Originality/valueMusic set interlending has a direct outcome in cultural fulfilment for thousands, perhaps millions, throughout the UK and is a rare area of growth, encouraging library use. Library managers would be wise to acknowledge this high level of activity, provision and value and give further financial and political support to music services as a vital weapon in the struggle to maintain quality library services in the UK.

Norway in UN environmental policies: ambitions and influence

This is a study of Norway’s ambitions for influencing UN environmental policies and then on the scope for impact. On the whole, it is clear that Norway has not been particularly successful in its general efforts at strengthening UNEP. These proposals have failed, due mainly to opposition from key states. Norway is after all a minor player in global governance issues, even in those pertaining to the environment. Norway has been more successful in efforts that indirectly strengthen UNEP, by supporting UNEP in initiating new MEAs. We found three main factors that help to explain why Norway has a relatively high level of influence at the international environmental arena compared to its size. First, there is a relatively straightforward domestic decision-making process with little conflict. Second, Norwegian officials and NGOs possess considerable expertise in these issues, adding to the intellectual leadership role of Norway in pushing for new principles and international legislation through UNEP. Third, Norway is sometimes able to join forces in environmental alliances with other like-minded countries. This would seem to carry the widest scope for increasing impact.

Context matters: interpreting impact findings in child survival evaluations

Appropriate consideration of contextual factors is essential for ensuring internal and external validity of randomized and non-randomized evaluations. Contextual factors may confound the association between delivery of the intervention and its potential health impact. They may also modify the effect of the intervention or programme, thus affecting the generalizability of results. This is particularly true for large-scale health programmes, for which impact may vary substantially from one context to another. Understanding the nature and role of contextual factors may improve the validity of study results, as well as help predict programme impact across sites. This paper describes the experience acquired in measuring and accounting for contextual factors in the Multi-Country Evaluation of the IMCI (Integrated Management of Childhood Illness) strategy in five countries: Bangladesh, Brazil, Peru, Uganda and Tanzania. Two main types of contextual factors were identified. Implementation-related factors include the characteristics of the health systems where IMCI was implemented, such as utilization rates, basic skills of health workers, and availability of drugs, supervision and referral. Impact-related factors include baseline levels and patterns of child mortality and nutritional status, which affect the scope for programme impact. We describe the strategies used in the IMCI evaluation in order to obtain data on relevant contextual factors and to incorporate them in the analyses. Two case studies - from Tanzania and Peru - show how appropriate consideration of contextual factors may help explain apparently conflicting evaluation results.

The Scope for Social Impact in Engineering Outcomes: A Diagrammatic Aid to Analysis

This Note presents ideas, and a resulting diagram, for use in analysis of social impact in the outcomes of engineering design. The diagram shows the degree of technical constraint in a design problem as a function of the independent variables type of design (radical to normal) and level of hierarchy within a systematic device (upper to lower). It is argued that technical constraint is greatest in normal design at the lower levels of hierarchy. On the (plausible) assumption that scope for social impact tends to decrease as technical constraint increases, these ideas have implications for the social study of technology.