The Spherical Tokamak for Energy Production (STEP) in context: UK public sector approach to fusion energy.

The UK's fusion energy approach has developed over the past 5 years to include government policy initiatives and a range of public sector investments designed to be delivered in partnership with the private sector. These have aimed to create an environment that stimulates innovation and investment to deliver economic as well as scientific and environmental benefits throughout the lifetime of the public sector fusion energy programme. The Spherical Tokamak for Energy Production acts as a focus and anchor for both public and private sector efforts to develop fusion energy, developing the supply chain and potential for Intellectual Property development and export opportunities well ahead of the anticipated STEP completion date of 2040. This is maximized by the UK's approach to a holistic research and innovation programme backed up by a regulatory and skills programme. This article is part of the theme issue 'Delivering Fusion Energy - The Spherical Tokamak for Energy Production (STEP)'.

The effect of Medicaid expansion on the take-up of disability benefits by race and ethnicity.

Public disability programs provide financial support to 12 million working-age individuals per year, though not all eligible individuals take up these programs. Mixed evidence exists regarding the impact of Medicaid eligibility expansion on program take-up, and even less is known about the relationship between Medicaid expansion and racial and ethnic disparities in take-up. Using 2009-2020 Current Population Survey data, we compare changes in Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) take-up among respondents with disabilities living in Medicaid expansion states to respondents with disabilities living in non-expansion states, before and after Medicaid expansion. We further explore heterogeneity by race/ethnicity. We find that Medicaid expansion reduced SSI take-up by 10% overall, particularly among White and Hispanic respondents (10% and 21%, respectively). Medicaid expansion increased SSDI take-up by 8% overall, particularly among White and Black respondents (9% and 11%, respectively). Moreover, we find that Medicaid expansion reduced the probability that respondents with disabilities had employer-sponsored health insurance by approximately 8%, suggesting that expansion may have reduced job-lock among the SSDI-eligible, contributing to the observed increase in SSDI take-up.

Achieving dynamic efficiency in pharmaceutical innovation: Identifying the optimal share of value and payments required.

It has been argued that cost-effectiveness analysis of branded pharmaceuticals only considers static efficiency, neglects dynamic effects and undermines incentives for socially valuable innovation. We present a framework for designing pharmaceutical pricing policy to achieve dynamic efficiency. We develop a coherent framework that identifies the long-term static and dynamic benefits and costs of offering manufacturers different levels of reward. The share of value that would maximise long-term population health depends on how the quantity and quality of innovation responds to payment. Using evidence of the response of innovation to payment, the optimal share of value of new pharmaceuticals to offer to manufacturers is roughly 20% (range: 6%-51%). Reanalysis of a sample of NICE technology appraisals suggests that, in most cases, the share of value offered to manufacturers and the price premium paid by the English NHS were too high. In the UK, application of optimal shares would offer considerable benefits under both a public health objective and a broader view of social welfare. We illustrate how an optimal share of value can be delivered through a range of payment mechanisms including indirect price regulation via the use of different approval norms by an HTA body.

Evaluating the effects of shelter-in-place policies during the COVID-19 pandemic.

We estimate the effects of shelter-in-place (SIP) orders during the first wave of the COVID-19 pandemic. We do not find detectable effects of these policies on disease spread or deaths. We find small but measurable effects on mobility that dissipate over time. And we find small, delayed effects on unemployment. We conduct additional analyses that separately assess the effects of expanding versus withdrawing SIP orders and test whether there are spillover effects in other states. Our results are consistent with prior studies showing that SIP orders have accounted for a relatively small share of the mobility trends and economic disruptions associated with the pandemic. We reanalyze two prior studies purporting to show that SIP orders caused large reductions in disease prevalence, and show that those results are not reliable. Our results do not imply that social distancing behavior by individuals, as distinct from SIP policy, is ineffective.

Global COVID-19 Policy Engagement With Scientific Research Information: Altmetric Data Study.

BACKGROUND: Previous studies on COVID-19 scholarly articles have primarily focused on bibliometric characteristics, neglecting the identification of institutional actors that cite recent scientific contributions related to COVID-19 in the policy domain, and their locations. OBJECTIVE: The purpose of this study was to assess the online citation network and knowledge structure of COVID-19 research across policy domains over 2 years from January 2020 to January 2022, with a particular emphasis on geographical frequency. Two research questions were addressed. The first question was related to who has been the most active in policy engagement with science and research information sharing during the COVID-19 pandemic, particularly in terms of countries and organization types. The second question was related to whether there are significant differences in the types of coronavirus research shared among countries and continents. METHODS: The Altmetric database was used to collect policy report citations of scientific articles for 3 topic terms (COVID-19, COVID-19 vaccine, and COVID-19 variants). Altmetric provides the URLs of policy agencies that have cited COVID-19 research. The scientific articles used for Altmetric citations are extracted from journals indexed by PubMed. The numbers of COVID-19, COVID-19 vaccine, and COVID-19 variant research outputs between January 1, 2020, and January 31, 2022, were 216,787, 16,748, and 2777, respectively. The study examined the frequency of citations based on policy institutional domains, such as intergovernmental organizations, national and domestic governmental organizations, and nongovernmental organizations (think tanks and academic institutions). RESULTS: The World Health Organization (WHO) stood out as the most notable institution citing COVID-19-related research outputs. The WHO actively sought and disseminated information regarding the COVID-19 pandemic. The COVID-19 vaccine citation network exhibited the most extensive connections in terms of degree centrality, 2-local eigenvector centrality, and eigenvector centrality among the 3 key terms. The Netherlands, the United States, the United Kingdom, and Australia were the countries that sought and shared the most information on COVID-19 vaccines, likely due to their high numbers of COVID-19 cases. Developing nations, although gaining quicker access to COVID-19 vaccine information, appeared to be relatively isolated from the enriched COVID-19 pandemic content in the global network. CONCLUSIONS: The global scientific network ecology during the COVID-19 pandemic revealed distinct types of links primarily centered around the WHO. Western countries demonstrated effective networking practices in constructing these networks. The prominent position of the key term "COVID-19 vaccine" demonstrates that nation-states align with global authority regardless of their national contexts. In summary, the citation networking practices of policy agencies have the potential to uncover the global knowledge distribution structure as a proxy for the networking strategy employed during a pandemic.

Climate change and government policy: Fresh insights from complexity theory.

Governments worldwide are increasingly concerned about ensuring a balance between economic and environmental well being. Global economies, particularly developing ones, emphasize the importance of achieving escofriendly growth to maintain the levels of the ecological footprint while achieving higher economic growth. The ecological footprint is a comprehensive indicator of environmental degradation. It is used to assess the state of the environment because it reflects the impact of all human activities on nature. This study contributes to the literature by offering a novel analytical approach for solving complex interactions of ecological footprint antecedents, advancing the theoretical reasoning behind how government policy combines to explain the ecological footprint from some G7 countries (France, Italy, Japan, United Kingdom, and Germany) from 1996 to 2020. To establish a composite score of environmental footprint, we used complexity theory as well as fuzzy set qualitative comparative analysis (fsQCA) and necessary condition analysis (NCA). Our analysis revealed that low expenditures on environmental protection and waste management, low taxes on transport, and high energy use are sufficient conditions to be included in the causal configurations for a high ecological footprint. Additionally, the sufficient solution, which has the highest coverage score that produces a low ecological footprint relies on high expenditure on environmental protection and high taxes on transportation. In this framework, Japan, Italy, and France have more effective government policies in terms of reducing the ecological footprint.

Intervention uncertainty, household health, and pandemic.

This study builds a policy choice model wherein household health status responds to the lockdown during the COVID-19 pandemic. Considering an exogenous policy-decision date, the model implies that the government should maintain the current policy if the perceived effects on infection are below a certain threshold. Specifically, the threshold is determined by policy uncertainty and household concerns regarding health service provision, which further controls the announcement effects of the lockdown. Higher policy uncertainty and concerns regarding health services will diminish the positive impact of the lockdown on household health status.

Results from Viet Nam's 2022 report card on physical activity for children and youth.

Background: The Active Healthy Kids 2022 Viet Nam Report Card provides an evidence-based assessment of 10 indicators of community and government-led initiatives that impact the physical activity levels of children and youth in Vietnam. Methods: A systematic framework developed by the Active Healthy Kids Global Alliance was used. Each indicator: Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behaviors, Physical Fitness, Family and Peers, School, Community and Environment, and Government, and a new indicator: Obesity was assessed against predefined benchmarks. EBSCOhost databases and Google Scholar were searched for relevant academic and grey literature (e.g., government reports) respectively to inform indicator grading. Results: The School indicator received the highest grade 'A', followed by the Government indicator which was graded as 'B-'. Three indicators (Sedentary Behaviors, Family and Peers, Community and Environment) received 'C' grades. Active Transportation was graded 'D+'. Overall Physical Activity received the lowest grade of 'F'. Organized Sport and Physical Activity, Active Play, and Physical Fitness were not graded due to lack of data. Obesity was graded B-. Conclusions: This is the first physical activity report card for children and adolescents in Viet Nam. Evidence suggests that Vietnamese children and adolescents have low physical activity levels and high levels of sedentary behaviors. Initiatives to promote physical activity in children predominantly focus on promoting physical education in schools. Increased community-based programs promoting physical activity outside of school settings are required. Future research should address the surveillance gap in Organized Sport and Physical Activity, Active Play, and Physical Fitness.

COVID-19 and income inequality: evidence from monthly population registers.

We measure the distributional impact of the COVID-19 pandemic using newly released population register data in Sweden. Monthly earnings inequality increased during the pandemic, and the key driver is income losses among low-paid individuals while middle- and high-income earners were almost unaffected. In terms of employment, as measured by having positive monthly earnings, the pandemic had a larger negative impact on private-sector workers and on women. In terms of earnings conditional on being employed, the effect was still more negative for women, but less negative for private-sector workers compared to publicly employed. Using data on individual take-up of government COVID-19 support, we show that policy significantly dampened the inequality increase, but did not fully offset it. Annual total market income inequality, which also includes capital income and taxable transfers, shows similar patterns of increasing inequality during the pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s10888-022-09560-8.

'Teachers are the guinea pigs': teacher perspectives on a sudden reopening of schools during the COVID-19 pandemic.

Primary and secondary education systems experienced substantial disruption during the COVID-19 pandemic. However, little is known about how public health policy has affected Australian teachers during the pandemic. This study examines teacher perspectives on a sudden change of policy, whereby schools were abruptly opened to students at the beginning of the pandemic. At the same time, strict social distancing rules applied to the remainder of the population. Qualitative data from 372 Western Australian schoolteachers were analysed using thematic analysis. Results highlight substantial impacts on teachers' workloads and adverse effects on wellbeing. Perceptions that they were acting as guinea pigs and subjected to different social distancing rules than other citizens were particular stressors. Findings highlight substantial consequences of public health policies on the roles and wellbeing of teachers.

A Population Health Approach to Transplant Access: Challenging the Status Quo.

Transplant referral and evaluation are critical steps to waitlisting yet remain an elusive part of the transplant process. Despite calls for more data collection on pre-waitlisting steps, there are currently no national surveillance data to aid in understanding the causes and potential solutions for the extreme variation in access to transplantation. As population health scientists, epidemiologists, clinicians, and ethicists we submit that the transplant community has an obligation to better understand disparities in transplant access as a first necessary step to effectively mitigating these inequities. Our position is grounded in a population health approach, consistent with several new overarching national policy and quality initiatives. The purpose of this Perspective is to (1) provide an overview of how a population health approach should inform current multisystem policies impacting kidney transplantation and demonstrate how these efforts could be enhanced with national data collection on pre-waitlisting steps; (2) demonstrate the feasibility and concrete next steps for pre-waitlisting data collection; and (3) identify potential opportunities to use these data to implement effective population-level interventions, policies, and quality measures to improve equity in access to kidney transplantation.

Biomaterials science and engineering to address unmet needs in women's health.

Medical conditions that primarily or disproportionately affect women have historically been poorly studied. In contrast to the musculoskeletal and cardiovascular systems, there is no lengthy record of biomaterials research addressing women's health needs. In this article, the historical reasons for this discrepancy are examined. The anatomy of both the nonpregnant and pregnant reproductive tissues is reviewed, including the ovaries, uterus, and (fetal) placenta. Examples of biomaterials-related women's health research are described, including tissue engineering, organoids, and microphysiological systems. The future of the field is considered with dual focuses. First, there is a significant need for novel approaches to advance women's health through materials and biomaterials, particularly in complex biomimetic hydrogels. Second, there is an exciting opportunity to enlarge the community of biomaterials scientists and engineers working in women's health to encourage more contributions to its rapidly emerging product development pipeline.

Pediatric diabetes in China: Challenges and actions.

Pediatric diabetes is growing in China. The annual incidence of childhood type 1 diabetes is about 2.02-5.3 per 100,000 person-years. Type 2 diabetes in children and adolescents is increasing dramatically with the high-speed urbanization of China. The prevalence of type 2 diabetes varies from 1.64/100, 000 to 15.16/100,000 based on the geography and economy. Monogenic diabetes used to be underestimated in China and now more cases are emerging. In this review, we give an overview of pediatric diabetes in China, present the progresses and challenges in management of pediatric diabetes, and discuss the government policy and potential actions in China, for better life quality of diabetic families.

Social acceptability of standard and behavioral economic inspired policies designed to reduce and prevent obesity.

The obesity epidemic is a significant public policy issue facing the international community, resulting in substantial costs to individuals and society. Various policies have been suggested to reduce and prevent obesity, including those informed by standard economics (a key feature of which is the assumption that individuals are rational) and behavioral economics (which identifies and harness deviations from rationality). It is not known which policy interventions taxpayers find acceptable and would prefer to fund via taxation. We provide evidence from a discrete choice experiment on an Australian sample of 996 individuals to investigate social acceptability of eight policies: mass media campaign; traffic light nutritional labeling; taxing sugar sweetened beverages; prepaid cards to purchase healthy food; financial incentives to exercise; improved built environment for physical activity; bans on advertising unhealthy food and drink to children; and improved nutritional quality of food sold in public institutions. Latent class analysis revealed three classes differing in preferences and key respondent characteristics including capacity to benefit. Social acceptability of the eight policies at realistic levels of tax increases was explored using post-estimation analysis. Overall, 78% of the sample were predicted to choose a new policy, varying from 99% in those most likely to benefit from obesity interventions to 19% of those least likely to benefit. A policy informed by standard economics, traffic light labeling was the most popular policy, followed by policies involving regulation: bans on junk food advertising to children and improvement of food quality in public institutions. The least popular policies were behaviorally informed: prepaid cards for the purchase of only healthy foods, and financial incentives to exercise.

The influence of climate factors and government interventions on the Covid-19 pandemic: Evidence from 134 countries.

This paper investigates at the world level the influence of climate on the transmission of the SARS-CoV-2 virus. For that purpose, panel regressions of the number of cases and deaths from 134 countries are run on a set of explanatory variables (air temperature, relative humidity, precipitation, and wind) along with control variables (government interventions and population size and density). The analysis is completed with a panel threshold regression to check for potential non-linearities of the weather variables on virus transmission. The main findings support the role of climate in the circulation of the virus across countries. The detailed analysis reveals that relative humidity reduces the number of cases and deaths in both low and high regimes, while temperature and wind reduce the number of deaths.

Workforce situation of the Chinese mental health care system: results from a cross-sectional study.

BACKGROUND: High-quality mental health services can improve outcomes for people with mental health problems and abate the burden of mental disorders. We sought to identify the challenges the country's mental health system currently faces and the human resource situation related to psychological services and to provide recommendations on how the mental health workforce situation could be addressed in China. METHODS: This study used a cross-sectional survey design. A web-based questionnaire approach and a convenience sampling method were adopted. It was carried out from September 2020 to January 2021 in China, and we finally included 3824 participants in the analysis. Descriptive statistical analysis of the characteristics of the study sample was performed. The risk factors for competence in psychological counseling/psychotherapy were assessed using multiple linear regression analysis. RESULTS: Workforce related to psychotherapy is scarce in China, especially in Western China and community mental health sectors. Psychiatrists (39.1%) and nurses (38.9%) were the main service providers of psychotherapy in psychiatric hospitals, and clinical psychologists (6.9%) and counsellors (5.0%) were seriously scarce in mental health care sectors. A total of 74.2% of respondents had no systematic psychological training, and 68.4 and 69.2% of them had no self-experience and professional supervision, respectively. Compared with clinical psychologists and counselors, psychiatrists and nurses had less training. Systematic psychological training (ß = - 0.88), self-experience (ß = - 0.59) and professional supervision (ß = - 1.26) significantly influenced psychotherapy capacity (P<0.001). CONCLUSIONS: Sustained effort will be required to provide a high-quality, equitably distributed psychotherapy workforce in China, despite challenges for community mental health sectors and western China being likely to continue for some time. Because mental illness is implicated in so many burgeoning social ills, addressing this shortfall could have wide-ranging benefits.

Evidence of co-creation practices in suicide prevention in government policy: a directed and summative content analysis.

BACKGROUND: In Australia, the collaborative involvement of stakeholders, especially those with lived experience in mental health and suicide prevention, has become important to government policy and practice at Federal and State levels. However, little is known about how governments translate this intention into frameworks of co-creation for policy, funding programs, service improvement, and research and evaluation. We investigated the extent to which publicly available government policies refer to collaborative practice using an established translation model. METHODS: An exploratory directed and summative content analysis approach was used to analyse the contents of Federal (also known as Commonwealth), State and Territories policy documents on mental health and suicide prevention published in Australia between 2010 and 2021. The data was extracted, compared to an existing translation model, and summated to demonstrate the evidence of co-creation-related concepts between government and stakeholders. RESULTS: 40 policy documents (nine at the Federal and 31 at the State and Territory level) were identified and included in the analysis. Only 63% of policy documents contained references to the concept of co-design. Six of the State policies contained references to the concept of co-production. Across all policy documents, there were no references to other concepts in the model adopted for this study, such as co-creation, co-ideation, co-implementation, and co-evaluation. CONCLUSION: Although the government at Federal, State and Territory levels appear to support collaborative practice through partnership and co-design, this study suggests a narrow approach to the theoretical model for co-creation at a policy level. Implications for both research and practice are discussed.

Implementing healthy food environment policies in New Zealand: nine years of inaction.

BACKGROUND: The INFORMAS [International Network for Food and Obesity/Non-communicable Diseases (NCDs) Research, Monitoring and Action Support] Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. METHODS: In March-April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 "good practice" policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritized concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. RESULTS: In 2020, 60% of the indicators were rated as having "low" or "very little, if any" implementation compared to international benchmarks: less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multisectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. CONCLUSIONS: There has been little to no progress in the past three terms of government (9 years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many government entities to overcome the existing policy inertia. The increase in food insecurity due to COVID-19 lockdowns may provide the impetus to stimulate action on food polices.

Tracking social media during the COVID-19 pandemic: The case study of lockdown in New York State.

Facing the COVID-19 pandemic, governments have implemented a wide range of policies to contain the spread of the virus. During the pandemic, large amounts of COVID-19-related tweets emerge every day. Real-time processing of daily tweets may offer insights for monitoring public opinion about intervention measures implemented. In this work, lockdown policy in New York State has been set as a target of public opinion research. This task includes two stages, stance detection and opinion monitoring. For the stance detection stage, we explored several combinations of different text representations and classification algorithms, finding that the combination of Long Short-Term Memory (LSTM) with Global Vectors for Word Representation (GloVe) outperforms others. Due to the shortage of labeled data, we adopted the data distillation method for the training data augmentation. The augmentation of the training data allows to improve the performance of the model with a very small amount of manually-labeled data. After applying the distillation method, the accuracy of the model has been significantly improved. Utilizing the enhanced model, automatically classified tweets are analyzed over time to monitor the public opinion. By exploring the tweets in New York from January 22nd until September 30th, 2020, we show the correlation of public opinion with COVID-19 cases and mortality data, and the effect of government responses on the opinion shift. These results demonstrate the capability of the presented method to effectively and efficiently monitor public opinion during a pandemic.

COVID-19 regulations, culture, and the environment.

The economic and social disruptions caused by the COVID-19 pandemic are immense. Unexpectedly, a positive outcome of the stringent Covid restrictions has come in the form of air pollution reduction. Pollution reduction, however, has not happened everywhere at equal rates. Why are lockdown measures not producing this positive externality in all countries? Using satellite-based Aerosol Optical Depth data and panel analysis conducted at the country-day level, we find that the countries that have adopted stringent COVID-19 containment policies have experienced better air quality. Nonetheless, this relationship depends on the cultural orientation of a society. Our estimates indicate that the effect of policy stringency is lower in societies imbued with a collectivistic culture. The findings highlight the role of cultural differences in the successful implementation of policies and the realization of their intended outcomes. It implies that pollution mitigation policies are less likely to yield emission reduction in collectivist societies.