public policy

公共政策
  • 文章类型: Journal Article
    《2030年可持续发展议程》中的关键问题之一是需要分类数据。鉴于2019年冠状病毒病(COVID-19)的性质,这方面的研究应该响应这一呼吁。本文调查了南非林波波省COVID-19疫苗接种状况的性别和其他观点。这项工作利用了家庭调查(n=4,571),数据来自我们的数据世界和约翰霍普金斯大学,以及政策文件和学术文献。调查结果是,政府偏离了实现67%的群体免疫力的目标,遏制战略。虽然该国35%的人口完全接种了疫苗,目前的研究显示,72.84%的受访者在林波波完全接种疫苗(包括那些接受加强疫苗接种的人).值得注意的发现包括7.1%的受访者报告部分疫苗接种,19.8%的受访者表示疫苗接种犹豫。性别差异显著,女性疫苗接种率高于男性,观察到与年龄相关的变化,尤其是最年轻的参与者。按性别和年龄组分层的进一步分析揭示了巨大的差异,强调需要有针对性的干预措施。此外,该研究突出了基于教育水平的COVID-19疫苗摄取模式,高等教育与疫苗接种率的提高有关。不同教育水平的疫苗摄取方面基于性别的显著差异表明有可能开展重点公共卫生工作。研究结果强调了影响疫苗接种行为的因素的复杂性,为决策者提供有价值的见解,公共卫生从业人员,以及旨在提高疫苗摄入量和解决不同人口群体差异的研究人员。
    One of the key issues embedded in the 2030 Agenda for Sustainable Development is the need for disaggregated data. Given the nature of the Coronavirus disease 2019 (COVID-19), studies on such should respond to this call. This paper investigates gendered and other perspectives on COVID-19 vaccination status in South Africa\'s Limpopo Province. The work utilises a household survey (n = 4,571), data from Our World in Data and Johns Hopkins University, as well as policy documents and academic literature. The findings are that the government moved away from a goal to attain 67% herd immunity, to the containment strategy. While the country attained 35% of population fully vaccinated, the current study reveals 72.84% of the respondents fully vaccinated in Limpopo (including those receiving a booster). Noteworthy findings include 7.1% of the respondents reporting partial vaccination and 19.8% expressing vaccine hesitancy. Gender differences were significant, with females exhibiting higher vaccination rates than males, and age-related variations were observed, particularly among the youngest participants. Further analysis stratified by gender and age groups unveiled substantial disparities, emphasizing the need for targeted interventions. Additionally, the study highlights patterns in COVID-19 vaccine uptake based on education levels, with higher education associating with increased vaccination rates. Significant gender-based differences in vaccine uptake across education levels indicate potential areas for focused public health efforts. The findings emphasise the complexity of factors influencing vaccination behaviour, providing valuable insights for policymakers, public health practitioners, and researchers aiming to enhance vaccine uptake and address disparities in diverse demographic groups.
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  • 文章类型: Journal Article
    在过去的20年里,等离子体已成为一种以“液态金”为特征的医疗手段,以表明其挽救生命的潜力。通过称为分馏的制造过程,等离子体,通过献血采集,变成血浆衍生医疗产品(PDMPs)。世界卫生组织(WHO)强调了PDMP对全球医疗保健的重要性,包括世卫组织基本药物标准清单上的一些PDMP。从供体收集血浆的过程,制造等离子体衍生处理,在全球范围内分配这些治疗需要协调在不同社会中运作的多个社会行为者,政治和经济背景,但在公共政策或社会科学的学术文献中很少受到关注。本文将介绍一组可以指导等离子体产品社会学的分析问题和概念。我们以政策科学中的行为转向为基础,以识别该领域出现的相关政策问题,并提供必要的分析工具,以研究该领域中不同的社会行为者如何产生等离子体的意义。要做到这一点,我们将借鉴健康和疾病社会学的关键概念。
    Over the past 20 years, plasma has become a medical treatment characterized as \"liquid gold\" to signal its lifesaving potential. Through a manufacturing process termed fractionation, plasma, collected through blood donation, is turned into Plasma Derived Medical Products (PDMPs). The World Health Organization (WHO) has underlined the importance of PDMPs for global health care, including a number of PDMPs on the WHO Model List of Essential Medicines. The process of collecting plasma from a donor, manufacturing plasma derived treatments, and distributing those treatments globally requires the coordination of multiple social actors operating in different social, political and economic contexts, but has received little attention in scholarly literature on public policy or the social sciences. This paper will introduce a set of analytic questions and concepts that can direct a sociology of plasma products. We build on the behavioral turn in the policy sciences to identify relevant policy questions emerging from this field and offer the analytic tools necessary to investigate how different social actors in this space make meaning of plasma. To do this, we will draw on key concepts in the sociology of health and illness.
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  • 文章类型: Journal Article
    目标:烟草零售商较多的地方的吸烟率较高,但是,这是因为零售商定位吸烟的人居住的地方,还是烟草供应是否会促使烟草使用,目前尚不清楚。在这项研究中,我们纵向比较了消费者需求和烟草供应的作用,烟草零售商密度与吸烟率的区域关联。
    方法:我们将从美国行为危险因素监测系统数据中得出的年度成人吸烟率估计值与从国家建立时间序列数据中计算的3080个县2000年至2010年的烟草零售商密度的年度估计值进行了合并。我们分析了3080个县的零售商密度与吸烟之间的关系,使用随机截距交叉滞后面板模型,并采用两种烟草零售商密度度量方法,捕获县可能的烟草零售商数量除以人口或土地面积。
    结果:两种密度模型都提供了显着的需求和供应效应的证据;在基于人口的模型中,1年内吸烟率与下一年烟草零售商密度的关联(标准化系数=0.038,p<0.01)约为烟草零售商密度与后续吸烟率的关联(0.017,p<0.01)的两倍.在基于土地面积的模型中,情况正好相反,其中供给效应(0.042,p<0.01)比需求效应(0.003,p<0.01)强10倍以上。
    结论:限制零售烟草的政策有可能降低吸烟流行率,但是将这些政策与减少消费者需求的干预措施相结合仍然很重要。
    OBJECTIVE: Places with more tobacco retailers have higher smoking prevalence levels, but whether this is because retailers locate where people who smoke live or whether tobacco availability prompts tobacco use is unknown. In this study, we compare the role of consumer demand with that of tobacco supply in longitudinal, area-based associations of tobacco retailer density with smoking prevalence.
    METHODS: We merged annual adult smoking prevalence estimates derived from the USA Behavioural Risk Factor Surveillance System data with annual county estimates of tobacco retailer density calculated from the National Establishment Time Series data for 3080 counties between 2000 and 2010. We analysed relationships between retailer density and smoking in 3080 counties, using random intercept cross-lagged panel models and employing two measures of tobacco retailer density capturing the number of likely tobacco retailers in a county divided by either the population or land area.
    RESULTS: Both density models provided evidence of significant demand and supply effects; in the population-based model, the association of smoking prevalence in 1 year with tobacco retailer density in the next year (standardised coefficient=0.038, p<0.01) was about double the association between tobacco retailer density with subsequent smoking prevalence (0.017, p<0.01). The reverse was true in the land area-based model, where the supply effect (0.042, p<0.01) was more than 10 times stronger than the demand effect (0.003, p<0.01).
    CONCLUSIONS: Policies that restrict access to retail tobacco have the potential to reduce smoking prevalence, but pairing such policies with interventions to reduce consumer demand remains important.
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  • 文章类型: Journal Article
    背景:以妇女为中心的护理:澳大利亚产妇服务的战略方向(战略),2019年11月发布,为有效提供产妇护理提供国家指导。该战略围绕四个核心价值观(安全,尊重,选择,和访问)支持十二个以妇女为中心的护理原则。
    目的:探讨获得澳大利亚生育服务的妇女的经历是否与该战略的价值观和原则相一致。
    方法:邀请在2020年1月至2023年6月期间在澳大利亚完成了整个孕产期护理的妇女参加在线调查。根据战略的价值观和原则,妇女的经验及其与护理模式的联系,年龄,居住地,教育程度,报告了家庭收入。
    结果:调查由1750名女性完成。一定比例的女性认为该战略的价值观没有反映在她们所经历的护理中。在最低的时候,只有50.3%的女性接受了大部分或总是与价值观相一致的护理,最高为85.9%。根据该战略,接受私人护理模式的妇女更有可能接受护理。接受标准和高风险公立医院护理的妇女,农村/偏远地区的妇女,年轻女性不太可能接受相应的护理。人们普遍认为产后护理会更糟。
    结论:尽管阐明了应如何提供澳大利亚的产妇护理,该战略的意图尚未完全实现。在整个孕产期,女性获得护理的机会和经历都存在不平等。
    BACKGROUND: Women Centred Care: Strategic directions for Australian maternity services (the Strategy), released in November 2019, provides national guidance on effective maternity care provision. The Strategy is structured around four core values (safety, respect, choice, and access) underpinning twelve woman-centred care principles.
    OBJECTIVE: To explore whether the experiences of women who accessed Australian maternity services were aligned with the Strategy\'s values and principles.
    METHODS: Women who had completed an entire maternity care episode in Australia between January 2020 and June 2023 were invited to participate in an online survey. Women\'s experiences according to the Strategy\'s values and principles and their association with model of care, age, place of residence, educational attainment, and household income are reported.
    RESULTS: The survey was completed by 1750 women. A proportion of women perceived the Strategy\'s values were not reflected in the care they experienced. At its lowest, only 50.3 % of women received an aspect of care that mostly or always aligned with the values, and 85.9 % at its highest. Women in private models of care were more likely to experience care according to the Strategy. Women in standard and high-risk public hospital care, rural/remote dwelling women, and younger women were less likely to experience care accordingly. Care was universally perceived to be worse in the postnatal period.
    CONCLUSIONS: Despite articulating how Australian maternity care should be provided, the intent of the Strategy has not been fully realised. Inequities exist in women\'s access to and experiences of care across the entire maternity episode.
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  • 文章类型: Journal Article
    随着人们对保护生态系统功能和服务的日益关注,政府制定了公共政策,组织通过其网站免费提供了大量数字数据。另一方面,通过遥感源获取数据以及通过地理信息系统(GIS)和统计工具进行处理的进展,允许前所未有的能力来有效地管理生态系统。然而,这方面的现实世界仍然自相矛盾。原因可能是多种多样的,但是一个强有力的候选人与利益方之间的有限参与有关,这阻碍了所有这些资产的行动。该研究的目的是证明通过将现有的环境政策与环境大数据以及低成本的GIS和数据处理工具相结合,可以显着改善生态系统服务的管理。以位于米纳斯吉拉斯州(巴西)的上RiodasVelhas水文盆地为例,这项研究展示了基于环境变量多样性的主成分分析如何将子流域组装成城市,农业,采矿和异质概况,将生态系统服务的管理指导到最合适的官方制定的保护计划。GIS工具的使用,另一方面,允许将每个计划的实施范围缩小到特定的子盆地。针对许多保护计划,讨论了将优惠管理计划优化分配到优先区域的方法。一个典型的例子是所谓的保护使用潜力(CUP),专门用于保护含水层补给(提供服务)和控制水蚀(调节服务),以及根据土壤能力分配用途(支持服务)。在所有情况下,计划实施准备效率的提高和资源的节约被认为是值得注意的。
    With the growing concerns about the protection of ecosystem functions and services, governments have developed public policies and organizations have produced an awesome volume of digital data freely available through their websites. On the other hand, advances in data acquisition through remote sensed sources and processing through geographic information systems (GIS) and statistical tools, allowed an unprecedent capacity to manage ecosystems efficiently. However, the real-world scenario in that regard remains paradoxically challenging. The reasons can be many and diverse, but a strong candidate relates with the limited engagement among the interest parties that hampers bringing all these assets into action. The aim of the study is to demonstrate that management of ecosystem services can be significantly improved by integrating existing environmental policies with environmental big data and low-cost GIS and data processing tools. Using the Upper Rio das Velhas hydrographic basin located in the state of Minas Gerais (Brazil) as example, the study demonstrated how Principal Components Analysis based on a diversity of environmental variables assembled sub-basins into urban, agriculture, mining and heterogeneous profiles, directing management of ecosystem services to the most appropriate officially established conservation plans. The use of GIS tools, on the other hand, allowed narrowing the implementation of each plan to specific sub-basins. This optimized allocation of preferential management plans to priority areas was discussed for a number of conservation plans. A paradigmatic example was the so-called Conservation Use Potential (CUP) devoted to the protection of aquifer recharge (provision service) and control of water erosion (regulation service), as well as to the allocation of uses as function of soil capability (support service). In all cases, the efficiency gains in readiness for plans\' implementation and economy of resources were prognosed as noteworthy.
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  • 文章类型: Journal Article
    仇恨犯罪已成为全球奖学金中越来越熟悉的术语,概念理解和经验知识的进步有助于在世界许多地方产生更好的政策反应。然而,“其他身份”的持续妖魔化,全球仇恨事件的数量不断增加,紧张局势不断加剧,资源的减少和政治上的不优先地位都表明,许多紧迫的挑战仍然存在。这一特别问题的撰稿人消除了共同的陈规定型观念和误解,这些陈规定型观念和误解阻碍了我们处理当代仇恨和暴力表达的集体能力。在这样做的时候,他们从他们的研究证据,以确定“隐藏的”挑战,这些挑战应该站在试图解决原因的最前沿,影响,防止一切形式的暴力。这要求重新配置是贯穿每篇文章的统一主题,这为更细致的分析铺平了道路,为应对多样化和不断变化的暴力模式提供了新的框架。这些是跨越学科界限的挑战,地理边界,和物理/数字世界,它要求国际社会,相交,和跨学科的观点在本期特刊中显而易见。
    Hate crime has become an increasingly familiar term within global scholarship, with advancements in conceptual understanding and empirical knowledge helping to generate improved policy responses across many parts of the world. However, the continued demonization of \'other\' identities, the escalating volume of hate incidents worldwide and the prevailing climate of rising tensions, decreasing resources and political de-prioritization all suggest that many urgent challenges remain. Contributors to this special issue have dismantled common stereotypes and misperceptions which hamper our collective capacity to address contemporary expressions of hate and violence. In doing so, they draw from their research evidence to identify \"hidden\" challenges which should be at the forefront of attempts to address the causes, effects, and prevention of all forms of violence. This call for reconfiguration is the unifying theme which runs through each article, and which paves the way for more nuanced analyses that offer new frameworks for responding to the diverse and changing patterns of violence. These are challenges which straddle disciplinary boundaries, geographical borders, and the physical/digital world, and which demand the international, intersectional, and interdisciplinary perspectives evident within this special issue.
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  • 文章类型: Journal Article
    旨在在巴西传播有关自杀预防的信息,“SetembroAmarelo”运动自2015年以来一直在进行。这项研究的目的是评估这项运动与12年内老年人自杀率之间的关系。
    数据来自死亡率信息系统和应报告疾病信息系统,由巴西的公共机构建立。应用了中断的时间序列框架来评估“SetembroAmarelo”运动与巴西东南部老年人口(60等人以上)的自杀死亡率之间的关联。我们考虑三个月的结果:所有自杀,男性自杀和女性自杀。我们在假设三个效果的情况下实施这场运动:短期,下降和持续。分析期间为2011-2022年。
    随着时间的推移,自杀死亡率保持稳定;运动前期间的平均比率为0.028,并略有增加至0.035。无论竞选活动的运作和使用的结果如何,结果显示运动与老年人自杀率之间没有显著关联.该运动在短期内与15%(P=0.532)的无显著下降效应相关。和16%(P=0.446)假设运动是持续的。
    竞选和自杀率之间缺乏关联,在巴西东南部地区的老年人中。由于自杀是复杂和多因素的,需要更多的研究。这场运动,在提高认识和减少耻辱的同时,不能减少自杀。降低老年人的自杀率需要解决社会问题,经济和文化因素,多部门干预,维护基本人权。
    UNASSIGNED: Aiming to disseminate information related to suicide prevention in Brazil, the \"Setembro Amarelo\" campaign has been conducted since 2015. The objective of this study is to assess the association between this campaign and elderly suicide rates over a 12-year period.
    UNASSIGNED: Data were gathered from the Mortality Information System and the Notifiable Diseases Information System, established by public institutions in Brazil. An interrupted time-series framework was applied to assess the association between the \"Setembro Amarelo\" campaign and suicide mortality rates in the elderly population (60 et plus) in the southeastern region of Brazil. We consider three monthly outcomes: all suicides, suicides in males and suicide in females. We operationalize the campaign assuming three effects: short-term, declining and sustained. The period of analysis was from 2011-2022.
    UNASSIGNED: The suicide-mortality rate over time has remained stable; the average rate in the pre-campaign period was 0.028 and increased slightly to 0.035. Regardless of the campaign\'s operationalization and the outcome used, results show no significant associations between the campaign and elderly suicide rates. The campaign was associated with non-significant decreased effects of 15% (P=0.532) in the short term, and 16% (P=0.446) assuming the campaign was sustained.
    UNASSIGNED: There is a lack of association between the campaign and suicide rates, among the elderly in Brazil\'s southeastern region. As suicide is complex and multifactorial, more research is needed. The campaign, while raising awareness and reducing stigma, may not reduce suicides. To reduce the suicide rate in the elderly requires addressing social, economic and cultural factors, multisectoral interventions, and upholding basic human rights.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: English Abstract
    People over 65 years of age will constitute the majority of the world\'s population in the short term, but in precarious living conditions: more years in a worse condition of vulnerability and fragility. Societies and development models would not be prepared, generating high personal, family and collective costs. In Chile, fragility would be highly prevalent in this population, impacting the full development of their lives; with sexuality as one of the aspects that are invisible and little studied. This work makes a critical approach, based on the review and analysis of context, public policies and legislation in force in Chile, evidencing atomization and biomedical orientation of public policies, collaborating in the understanding of the relationship between fragility and sexuality in old people; and revealing pending training and research tasks for the generation of public policies for an active and healthy life.
    Las personas mayores de 65 años constituirán la mayoría de la población mundial en corto plazo, pero en condiciones de vida precarias. Esto quiere decir que vivirán más años en peor condición de vulnerabilidad y fragilidad. Las sociedades y modelos de desarrollo no estarían preparados, generando altos costos personales, familiares y colectivos. En Chile la fragilidad sería altamente prevalente en esta población, impactando el desarrollo pleno de su vida. La sexualidad es uno de los aspectos que son invisibilizados y poco estudiados. Este trabajo realiza una aproximación crítica, a partir de la revisión y análisis de antecedentes de contexto, políticas públicas y legislación vigentes en Chile. En estos aspectos se evidencia atomización y orientación biomédica de las políticas públicas, colaborando en la comprensión de la relación fragilidad y sexualidad en personas mayores. Además, se revelan tareas de formación e investigación pendientes para la generación de políticas públicas para una vida activa y saludable.
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  • 文章类型: Journal Article
    容量与结果的关系在医疗保健中是众所周知的。经验曲线,最初由波士顿咨询集团开发用于制造,提供了对这种关系的洞察力,以前从未应用于医疗保健。
    这项研究的目的是确定经验对Cone程序的成本和资源利用率的影响。
    我们对2010年10月至2021年10月期间在波士顿儿童医院因Ebstein异常而接受Cone重建的患者进行了回顾性研究。使用指数回归评估随时间变化的心肺转流时间和主动脉阻断时间,以评估外科医生水平的学习曲线。在医院层面,使用指数回归评估住院时间和费用随时间的变化.
    该研究包括115名患者。平均住院天数为7.9天(IQR:6.4-10.2天),每年下降3.3%。重症监护病房[ICU]的中位住院时间为3.2天(IQR:2-5.7天),每年下降10.5%。与2020年价格挂钩的调整后直接成本每年下降4%。体外循环或主动脉阻断时间无统计学意义变化。在调解分析中,费用的降低完全归因于ICU住院时间的缩短.ICU住院时间与插管时间相关。
    对Ebstein异常和Cone重建的熟悉程度不断提高,导致资源利用率降低。
    UNASSIGNED: The volume-outcome relationship is well-known in health care. The Experience Curve, initially developed by the Boston Consulting Group for manufacturing, offers insight on this relationship and has never before been applied to health care.
    UNASSIGNED: The purpose of this study was to determine the effect of experience on cost and resource utilization for the Cone procedure.
    UNASSIGNED: We performed a retrospective review of patients who underwent Cone reconstruction for Ebstein\'s anomaly at Boston Children\'s Hospital between October 2010 and October 2021. Cardiopulmonary bypass time and aortic cross clamp time over time were evaluated using exponential regression to assess the surgeon-level learning curve. At the hospital level, length of stay and cost over time were assessed using exponential regression.
    UNASSIGNED: There were 115 patients included in the study. Median hospital length of stay was 7.9 days (IQR: 6.4-10.2 days) with a decline of 3.3% per year. Median intensive care unit [ICU] length of stay was 3.2 days (IQR: 2-5.7 days) with a decline of 10.5% per year. Adjusted direct costs indexed to 2020 prices fell by 4% per year. There was no statistically significant change in cardiopulmonary bypass or aortic cross clamp time. In mediation analysis, the reduction in cost was completely accounted for in the decline in ICU length of stay. ICU length of stay was correlated with duration of intubation.
    UNASSIGNED: Increasing familiarity with Ebstein\'s anomaly and Cone reconstruction led to a reduction in resource utilization.
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