Standard Policy Research Articles

Reintegrating Essential Child Life Programs During the COVID-19 Pandemic to Optimize Development and Normalization of Hospital Experiences for Pediatric Patients

BackgroundThe COVID-19 pandemic halted all in person and group Child Life Programs (CLP) for pediatric patients at a high acuity children's hospital. Play therapy and social development is interwoven with medical care for pediatric patients to normalize the hospital experience. We determined a safe way to provide these programs during the long-term pandemic management could be established by following guidelines established by the Centers for Disease Control (CDC), local public health guidelines, and our hospital infection control policies.MethodsThe CDC and local county guidelines provided guidance for managing and limiting COVID-19 exposure to patients and staff. Using these guidelines of masking, social distancing, limiting in person interactions to essential personnel only, daily health screening of staff and visitors, and the use of standard infection control policies, the Infection Preventionist and Director of Child Life services created reactivation plans for Pet Therapy, Playrooms, and the hospital Studio.ResultsUsing a three-phase approach, reactivation plans were developed for Pet Therapy, Playrooms, and the hospital Studio. Pet Therapy had designated areas and days while the dogs were attended by a hand hygiene champion when working. Playrooms and Studio sessions were one patient, one caregiver, and one Child Life Specialist/staff member at a specified interval of time; all toys and furniture were cleaned and prepped between patients. These reactivation plans have successfully begun transitioning into their second phase.ConclusionsCLP play a vital role in the care of pediatric patients. With COVID-19 guidelines in place, some activities can be reactivated while other activities can go digital/online. While modifications to routine CLP are required during the COVID-19 pandemic, some programs can be safely implemented. These programs provide enhanced play therapy and help pediatric patients adjust to the hospital environment. No COVID-19 exposures have occurred since the activation of these plans.

A COMPREHENSIVE CYBERSECURITY FRAMEWORK FOR AFGHANISTAN’S CYBERSPACE

Need for cyber security framework to protect the evolving ICT Infrastructure and Cyberspace in the modern information society does not need any emphasis. Given the importance of cyber space for country development, many countries have invested large amount of money for cyber space application. Since, based on official documents, Afghanistan is in the process of integrating ICT into its critical information infrastructure, to this end, the country may face various challenges including cyber security. Due to various potential threats and risks to Afghanistan cyber security, a comprehensive cyber security infrastructure and strategy is necessary. Accordingly, Afghanistan has introduced an ICT security law. However, nowadays internet is involving great portion of government and nongovernment sections. The country must introduce a comprehensive and appropriate cybersecurity framework and strategy to tackle all of the issues and risks related to this arena. With the introduction of different ICT based technologies in the country, Afghanistan is moving towards embracing electronic culture in its day-to-day dealings. As these technologies are becoming popular and being widely used, it is important to put in place technological infrastructure and legal frameworks, which will safeguard the private and enterprise data flowing through these ICT based infrastructures. The aim of this paper is to propose a comprehensive cybersecurity framework for Afghanistan’s cyberspace in order to protect and assure data, information and IT infrastructure security in cyberspace, enhance capacities to prevent and response to cyber threats, protect the nation from the risk and vulnerability, damage from modern cyber threats and incidents through a variety of standardized institutional structures, policies and procedures, and eventually establish and achieve a Safe – Secure and Resilient cyber space for the government, businesses and citizens of Afghanistan.

Implementation of a National Identity Number-Based Identity Card Policy In Pasangkayu Regency

The policy development mechanism for the national identity number -based electronic ID card software is described in this report. In this analysis, a qualitative procedure was used in conjunction with a case study technique. The total number of informants was 19. Employees from the government who work on the national identity number -based electronic identification card software make up this group. The culture is often used as a source of information in this report. The findings of the study indicate that; Every organ and implementor personnel at every level in every Pasangkayu sub-district office understands and implements national Identity Number -based electronic identification card policy requirements and goals, namely: first, citizens with a identification card condition have the right to get a electronic identification card, which the government is required to promote. Second, get closer to the position where the community resides, in this case the office respective districts, such that the community is not inconvenienced and burdened, must go to the Disdukcapil office in the district capital. Third, since these programs are provided free of charge or at no expense to government, this approach would not impose an economic burden. Fourth, this proposal has little effect on the district's spending schedule. As a result, success policy is essentially an evaluation of how well expectations and policy priorities have been met. As a result, the policy's standards and objectives must be practical and specifically targeted, and any implementation entity (implementor) must be aware of the policy's standards and objectives.

Poverty in Central Java using Multivariate Adaptive Regression Splines and Bootstrap Aggregating Multivariate Adaptive Regression Splines

Population poverty is one of the serious problems in Indonesia. The percentage of population poverty used as a means for a statistical instrument to be guidelines to create standard policies and evaluations to reduce poverty. The aims of the research are to determine model population poverty using MARS and Bagging MARS then to understand the most influence variable population poverty of Central Java Province in 2018. The result of this research is the Bagging MARS model showed better accuracy than the MARS model. Since, GCV value in the Bagging MARS model is 0,009798721 and GCV value in the MARS model is 6,985571. The most influential variable poverty population of Central Java Province in 2018 in the MARS model is the percentage of the old school expectation rate (X9). Then, the most influential variable in the Bagging MARS model is the number of diarrhea (X1).

Perceived work exposures and expressed intervention needs among Michigan nail salon workers.

BackgroundNail salon workers are an underserved population exposed to various occupational hazards. Comprised primarily of women and immigrants, these workers face challenges that further increase their workplace exposures and adverse health outcomes. Though previous studies have noted nail salon workers’ exposures, these studies have yet to explore the workers’ insights on intervention needs. This study among Michigan nail salon workers addresses this gap.MethodsThis qualitative study was informed by the phenomenology methodological framework anchored within critical social theory. Participants were recruited from nail salons in Southeast Michigan to partake in focus groups. Interviews were recorded, transcribed, and analyzed using content analysis.ResultsThree focus groups were conducted with 13 participants. Three major categories emerged. The first category, workers’ perceived work-related stressors, included six themes: lack of standardized policies, regulations, education/training; disconnect between education/training and real-world practice; inadequate knowledge on exposures and safety protocols; unsafe nail products; customer pressure; and immigrant-related pressures. The second category, health issues perceived to be directly related to workplace exposures, included two themes: symptoms experienced due to contact with nail products and symptoms due to poor ergonomics. The third category, participants’ perceived intervention needs, included four themes: continuing education; updates with new products; communication with key stakeholders; and partnership building and resource access.ConclusionsTo our knowledge, this is the first qualitative study among U.S. nail salon workers focused in Midwest. In addition to the noted individual and organizational-level interventions, policy level implications are discussed given discrepancies in training and practices across states.

Classroom Placement and Twins' Social Behaviors in Elementary School: Providing Empirical Evidence to Inform Educational Policy.

Classroom placement of twins is an ongoing issue for educational policy. Many educational jurisdictions have standard policy most commonly founded in the belief that separation supports individual identity, personal development and academic opportunity. This study examined the effects of classroom placement in a sample of 560 twin pairs whose behaviors were assessed from ages 5 to 12 years. We found no detrimental effect of classroom sharing on twins’ social development. In contrast, this study provides evidence that educating twins together is associated with modest positive twins’ behaviors and social functioning at school. Implications for educational policies are further discussed.

Disposal Practices of Unused and Leftover Medicines in the Households of Dhaka Metropolis.

Background: This fact-finding study aimed to attain an overall idea and knowledge about medicine disposal practices in Dhaka Metropolitan households. Methods: This mixed study (both quantitative and qualitative) was orchestrated to inspect the household leftover medicine disposal pattern’s governing status. A cross-sectional survey was conducted following a structured questionnaire and key informant interview with a household person and in-depth interviews with the top pharmaceutical and government officials. Results: Findings disclose that, for most of the key informants, the terms “drug disposal” and “drug pollution” were unknown; more precisely, 67% and 74% of key informants even did not hear these two terms. Almost all (87%) households faced undesired incidents due to the insecure storage of medicines. People disposed of excess and expired medication in regular dustbins (47%), threw out of the window (19%), flushed within commode (4%), burnt in fire (2%), and reused (4%). A good percentage of people (21%) returned unexpired drugs to the pharmacy and bought other medicines on a need basis. A total of 72% wanted a medicine take-back program, and 100% agreed on mass education on this issue. Officials of pharmaceuticals conferred mixed opinion: top-ranked pharmaceuticals will adopt leftover medicine disposal practices; middle and low-ranked pharmaceutical companies are reluctant, merely denied mentioning the less important issue. Conclusions: The absence of mass awareness and standard laws and policies may explain these existing aberrant practices.

Integrating Emerging Polymer Chemistries for the Advancement of Recyclable, Biodegradable, and Biocompatible Electronics.

Through advances in molecular design, understanding of processing parameters, and development of non‐traditional device fabrication techniques, the field of wearable and implantable skin‐inspired devices is rapidly growing interest in the consumer market. Like previous technological advances, economic growth and efficiency is anticipated, as these devices will enable an augmented level of interaction between humans and the environment. However, the parallel growing electronic waste that is yet to be addressed has already left an adverse impact on the environment and human health. Looking forward, it is imperative to develop both human‐ and environmentally‐friendly electronics, which are contingent on emerging recyclable, biodegradable, and biocompatible polymer technologies. This review provides definitions for recyclable, biodegradable, and biocompatible polymers based on reported literature, an overview of the analytical techniques used to characterize mechanical and chemical property changes, and standard policies for real‐life applications. Then, various strategies in designing the next‐generation of polymers to be recyclable, biodegradable, or biocompatible with enhanced functionalities relative to traditional or commercial polymers are discussed. Finally, electronics that exhibit an element of recyclability, biodegradability, or biocompatibility with new molecular design are highlighted with the anticipation of integrating emerging polymer chemistries into future electronic devices.

Newton Optimization on Helmholtz Decomposition for Continuous Games

Many learning problems involve multiple agents optimizing different interactive functions. In these problems, the standard policy gradient algorithms fail due to the non-stationarity of the setting and the different interests of each agent. In fact, algorithms must take into account the complex dynamics of these systems to guarantee rapid convergence towards a (local) Nash equilibrium. In this paper, we propose NOHD (Newton Optimization on Helmholtz Decomposition), a Newton-like algorithm for multi-agent learning problems based on the decomposition of the dynamics of the system in its irrotational (Potential) and solenoidal (Hamiltonian) component. This method ensures quadratic convergence in purely irrotational systems and pure solenoidal systems. Furthermore, we show that NOHD is attracted to stable fixed points in general multi-agent systems and repelled by strict saddle ones. Finally, we empirically compare the NOHD's performance with that of state-of-the-art algorithms on some bimatrix games and continuous Gridworlds environment.

Stepwise ABC system for classification of any type of genetic variant

The American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG-AMP) system for variant classification is score based with five classes: benign, likely benign, variant of unknown significance (VUS), likely pathogenic, and pathogenic. Here, we present a variant classification model that can be an add-on or alternative to ACMG classification: A stepwise system that can classify any type of genetic variant (e.g., hypomorphic alleles, imprinted alleles, copy number variants, runs of homozygosity, enhancer variants, and variants related to traits). We call it the ABC system because classification is first functional (A), then clinical (B), and optionally a standard comment that fits the clinical question is selected (C). Both steps A and B have 1–5 grading when knowledge is sufficient, if not, class “zero” is assigned. Functional grading (A) only concerns biological consequences with the stages normal function (1), likely normal function (2), hypothetical functional effect (3), likely functional effect (4), and proven functional effect (5). Clinical grading (B) is genotype–phenotype focused with the stages “right type of gene” (1), risk factor (2), and pathogenic (3–5, depending on penetrance). Both grades are listed for each variant and combined to generate a joint class ranging from A to F. Importantly, the A–F classes are linked to standard comments, reflecting laboratory or national policy. In step A, the VUS class is split into class 0 (true unknown) and class 3 (hypothetical functional effect based on molecular predictions or de novo occurrence), providing a rationale for variant-of-interest reporting when the clinical picture could fit the finding. The system gives clinicians a better guide to variant significance.

The long goodbye on a disappearing, ancestral island: a just retreat from Isle de Jean Charles.

Climate change will necessitate evermore frequent and complex managed retreats in the future, and drafting policies that are equitable and just for those residents who are relocating will be essential. The USA’s first federally funded, community-scale, climate-driven resettlement is currently underway in coastal Louisiana. In January 2016, the U.S. Department of Housing and Urban Development (HUD) awarded the state of Louisiana $48.3 million to plan, design, and implement a structured, just, and scalable resettlement with former and current Isle de Jean Charles residents. Most Island households are multi-generational and directly descended from Jean Marie Naquin, after whose father the Island is named. Using interviews, ethnographic data, and policy documents, this paper will delineate and analyze the dimensions of sense of place, which, in this case, prompted policy changes dramatically different from standard relocation policies: assurance that the properties and land from which residents are departing will remain in their possession as long as the land remains. For most Island residents, this was non-negotiable. The intangible connection to place—feelings of belonging, lifestyle, family connections, and culture—plays a central role in many families’ decision to stay or go. The choice to relocate is rooted in this complex entanglement of identity, familial ties, land loss, historical and current marginalization, and a way of life passed on by multiple generations. In forthcoming community resettlements, continued access and ownership of the properties being left behind should be considered as a critical component for planning just retreats.

Sources of inflation and the effects of balanced budgets and inflation targeting in developing economies

AbstractThis article presents a model in which distributional conflict and cross-sectoral interactions between demand and supply side forces determine inflation in developing countries. We show that the standard macroeconomic policy recommendations of inflation targeting and balanced budgets (i) increase volatility by amplifying external shocks and (ii) can lead to premature deindustrialization. The recent Brazilian experience is used to illustrate the argument.

A proposal for a legally enforceable no-fault compensation framework for clinical trial-related injury in Malaysia

ABSTRACT Clinical trials play a critical role in the development of life-enhancing and life-sustaining biomedical advances. It is costly and, regardless of how well-designed and ethically conducted, there are always inherent uncertainties which subsequently expose human participants to the risk of injuries or even death. In Malaysia, compensation for clinical trial-related injury has not been incorporated into standard national regulations or policies. Therefore, when clinical trial-related injuries do occur, such participants cannot be compensated by researchers, and with the absence of specific statutory laws governing trial-related injury within the local legal framework, aggrieved parties need to seek legal redress and can only depend on the existing tort laws. To propose a viable compensation framework, the existing compensation regulations and policies implemented in India and South Africa are analyzed, and their best principles have been recommended. This study proposes the implementation of a no-fault compensation framework in Malaysia which should be disbursed efficiently at minimum administrative cost. This proposed approach should be mandated by the amendment of current laws governing biomedical research and, in the interim, should be adopted voluntarily by research sponsors, institutions and investigators conducting clinical trials in Malaysia.

Optimal intergenerational transfers: Public education and pensions

In presence of imperfections in the education loan market, the standard policy response of intervening solely on the education front, funded through taxes and transfers, necessarily hurts the initial working population. The literature suggests compensating them via Pay-As-You-Go (PAYG) pensions as a possible solution. We carry out the optimal policy exercise of a utilitarian government in a dynamically efficient economy with pension and education support obeying the Pareto criterion. We find that expansion of one instrument along with the other emerges as the optimal response, however, once the complete market level of education is achieved, the optimal policy suggests phasing pensions out. Eventually, government leads the economy to an equilibrium with zero pension and the Golden Rule level of education. This is achieved by exploiting only market opportunities without relying on other factors including human capital externalities, general equilibrium effects, or socio-political factors. We complement our theoretical results with a numerical exercise and compute the optimal policy path under different initial conditions and parameter values.

Letmegrab Seller- Simple And Secure Way For Online Transaction

An online payment system allows a customer to make a payment to an online merchant or a service provider. Payment gateways, a channel between customers and payment processors, use various security tools to secure a customer’s payment information, usually debit or credit card information, during an online payment. However, the security provided by a payment gateway cannot completely protect a customer’s payment information when a merchant also has the ability to obtain the payment information in some form. Furthermore, not all merchants provide a secure payment environment to their customers and, despite having a standard payment policy, adhere to it. Consequently, this exposes a customer’s payment information to risks of being compromised or misused by merchants or stolen by hackers and spammers. In this thesis we propose a new approach to payment systems in which a customer’s payment information cannot be obtained by a merchant. A customer sends his payment information directly to a payment gateway and a payment gateway, upon verifying the transaction, sends a payment to the appropriate merchant. We use the Pedersen commitment scheme along with dual signatures to securely transfer funds to a merchant and protect a customer’s payment information from any Internet vulnerabilities.

A Retrospective Analysis of Neglected HIV-1 Patients With middle-level Viremia in Central China Based On Current Policy

Aim: Due to the conflict of policies, HIV-1 middle-level viremia during antiretroviral therapy is neglected in China, so its clinical management was retrospectively investigated. Materials & methods: The characteristics and clinical indicators of HIV-1 patients treated in 2016 were analyzed. Results: Of 4370 cases, 1.2% progressed to middle-level viremia and 5.4% had persistent viral loads of ≥1000 copies/ml. Age, transmission mode and the ‘test and treat’ ratio among the three groups were significantly different (p < 0.05). Ordinal regression analysis showed that younger patients with higher CD4 count at baseline achieved better viral suppression if they had treatment as soon as possible. Conclusion: The results supported the ‘test and treat’ policy and suggested that the current treatment standard and testing policies should be adjusted.

Disassembling Efforts to Legalize Opting-Out in Arizona: A Case Study of Legislative Politics

Background/Context Opt-out is a national movement based on local efforts as most notably expressed in New York. While studies have addressed opt-out demographics and local impact, fewer studies address the political activism that extends beyond the act of refusing specific tests to changing standardized testing policy. Purpose/Objective/Research Question/Focus of Study This case study extends understanding of the opt-out phenomenon by examining and disassembling a case of efforts to legalize opting-out of state-mandated testing through a state legislative process. The policy reform efforts are framed and disassembled through the discourse of the New Right and elements of the political spectacle. Setting This study is set in the Arizona State Legislature's 2015 and 2016 sessions. Population/Participants/Subjects This study follows the efforts of state legislative policy actors including state legislators, state department of education officials, the state teacher association, and parent opt-out activists. Research Design This is a qualitative case study examining three bills intending to legalize opting-out introduced across two state legislative sessions. Data Collection and Analysis Data were collected utilizing progressive theoretical sampling to identify key legislative policy actors and collect public statements regarding the pending legislation. Data focused on legislative hearings and floor votes publicly archived on the legislature's website. Text of the bills along with contemporary social and traditional media statements were also collected, as were interviews with two state legislators. Data were analyzed for themes arising from the participants themselves, for elements of the New Right discourse, and for elements of the political spectacle. Findings/Results The generally White and affluent demographics of this case's opt-out movement leadership reflect national patterns. Likewise, the movement leadership focused on themes of local control and privacy rights. This vaguely symbolic language combined with casting big government as enemies suggests a fluency in the spectacle of modern legislative politics. Ultimately, opt-out proponents compromised in favor of a new policy initiative reflecting themes of neoliberalism and neoconservatism, the Menu of Assessments. Conclusions/Recommendations The compromise with the experimental Menu of Assessments policy to gain more local control over tests while keeping the expectation of testing in place suggests a limited victory for democracy. However, the Arizona opt-out movement's legislative efforts might also be understood as tension within the hegemonic New Right coalition.

Outcome of noncritical COVID-19 patients with early hospitalization and early antiviral treatment outside the ICU

Background/aimDespite the fact that the COVID-19 pandemic has been going on for over 5 months, there is yet to be a standard management policy for all patients including those with mild-to-moderate cases. We evaluated the role of early hospitalization in combination with early antiviral therapy with COVID-19 patients in a tertiary care university hospital. Materials and methodsThis was a prospective, observational, single-center study on probable/confirmed COVID-19 patients hospitalized in a tertiary care hospital on COVID-19 wards between March 20 and April 30, 2020. The demographic, laboratory, and clinical data were collected. ResultsWe included 174 consecutive probable/confirmed COVID-19 adult patients hospitalized in the Internal Medicine wards of the University Adult Hospital between March 20 and April 30, 2020. The median age was 45.5 (19–92) years and 91 patients (52.3%) were male. One hundred and twenty (69%) were confirmed microbiologically, 41 (23.5%) were radiologically diagnosed, and 13 (7.5%) were clinically suspected (negative microbiological and radiological findings compatible with COVID-19); 35 (20.1%) had mild, 107 (61.5%) moderate disease, and 32 (18.4%) had severe pneumonia. Out of 171 cases, 130 (74.3%) showed pneumonia; 80 were typical, and 50 showed indeterminate infiltration for COVID-19. Patients were admitted within a median of 3 days (0-14 days) after symptoms appear. The median duration of hospitalization was 4 days (0-28 days). In this case series, 13.2% patients were treated with hydroxychloroquine alone, 64.9% with hydroxychloroquine plus azithromycin, and 18.4% with regimens including favipiravir. A total of 15 patients (8.5%) were transferred to the ICU. Four patients died (2.2%).ConclusionIn our series, 174 patients were admitted to the hospital wards for COVID-19, 69% were confirmed with PCR and/or antibody test. At the time of admission, nearly one fifth of the patients had severe diseases. Of the patients, 95.4% received hydroxychloroquine alone or in combination. The overall case fatality rate was 2.2%.

Heterogeneity in corporate debt structures and the transmission of monetary policy

We study how differences in the aggregate structure of corporate debt affect the transmission of monetary policy in a panel of euro area countries. We find that standard policy tightening shocks raise the cost of loans relative to corporate bonds. In economies with a high share of bond finance, the resultant rise in the overall cost of credit is less pronounced as a smaller portion of corporate debt is remunerated at the loan rate and firms further expand their reliance on bonds. In economies with a low share of bond finance, the rise in the cost of credit is reinforced by a shift in the composition of debt towards bank loans. As a consequence, a higher bond share goes along with a weaker transmission of short-term policy rate shocks to real activity. By contrast, the real effects of monetary policy shocks to longer-term yields strengthen with the share of bond finance in the economy.

Evaluating Supports for Learner Autonomy in ELT Textbooks

The promotion of language learner autonomy has become a standard policy ratified by many language education curricula. Textbooks, one of the key tools for curriculum implementation, have a crucial role in bringing the aspiration of learner autonomy into classroom practice. This study aims to evaluate how existing English textbooks used in Indonesia’s secondary schools support the development of learner autonomy, which is incorporated in current Indonesia’s curricular goals. Two frameworks, from Reinders (2010) and Nunan (1997), were used to evaluate the evidence and levels of supports for language learner autonomy development in five selected English textbooks. The evaluation shows that the current English textbooks have not provided enough tasks that support learner autonomy. When evident, supports are mostly at a very superficial level. The findings suggest that textbooks have not been adequately explored and exploited for developing language learner autonomy.