Evaluating complementaries among urban water, energy, infrastructure, and social Sustainable Development Goals in China.

Urban areas' performance in water, energy, infrastructure, and socio-economic sectors is intertwined and measurable through Sustainable Development Goals (SDGs) 6-13. Effective synergy among these is critical for sustainability. This study constructs an indicator framework that reflects progress towards these urban SDGs in China. Findings indicate underperformance in SDGs 8-11, suggesting the need for transformative actions. Through network analysis, the research reveals complementarities among these SDGs. Notably, the SDG space divides into socio-economic and ecological clusters, with SDG 6 (Clean Water and Sanitation) central to both. Additionally, SDG 8 (Decent Work and Economic Growth) and SDG 9 (Industry, Innovation, and Infrastructure) act as bridges, while greater synergies exist between SDG 12 (Responsible Consumption and Production) and SDG 13 (Climate Action). An in-depth view at the indicator-level shows a core-periphery structure, emphasizing indicators like SDG 6.2 (Wastewater Treatment Rate) and SDG 6.6 (Recycled Water Production Capacity per capita) as pivotal. This study confirms the urban SDG space's stability and predictiveness, underscoring its value in steering well-aligned policy decisions for sustainable growth.

Artificial intelligence and the politics of avoidance in global health.

For decades, global health actors have centered technology in their interventions. Today, artificial intelligence (AI) is emerging as the latest technology-based solution in global health. Yet, AI, like other technological interventions, is not a comprehensive solution to the fundamental determinants of global health inequities. This article gathers and critically appraises grey and peer-reviewed literature on AI in global health to explore the question: What is avoided when global health prioritizes technological solutions to problems with deep-seated political, economic, and commercial determinants? Our literature search and selection yielded 34 documents, which we analyzed to develop seven areas where AI both continues and disrupts past legacies of technological interventions in global health, with significant implications for health equity and human rights. By focusing on the power dynamics that underpin AI's expansion in global health, we situate it as the latest in a long line of technological interventions that avoids addressing the fundamental determinants of health inequities, albeit at times differently than its technology-based predecessors. We call this phenomenon the 'politics of avoidance.' We conclude with reflections on how the literature we reviewed engages with and recognizes the politics of avoidance and with suggestions for future research, practice, and advocacy.

Potential donor family behaviours, experiences and decisions following implementation of the Organ Donation (Deemed Consent) Act 2019 in England: A qualitative study.

BACKGROUND: In May 2020, England implemented "deemed consent" legislation, to make it easier for individuals to donate their organs and convey their decision when alive. Families are supposed to support the decision but can still override it if they disagree. We aimed to learn more about this changed role when families were approached about organ donation. METHODS: A qualitative study using semi-structured interviews with families, feedback from nurses, comparisons with audit data, and public involvement. We used framework analysis with a health systems perspective and utilitarian theory to explore if the law worked. FINDINGS: 103 participants were interviewed representing 83 potential donation cases. In 31/83 (37%) cases donation was fully supported, in 41/83 (49%) cases families supported retrieval of some organs, tissues and procedures, and in 11/83 (13%) cases families declined completely. Themes explaining why the law was not (yet) working included: Understanding and agreeing the family's role, confusion about deemed consent, not supporting the deceased expressed decisions, organ donation as too much of a harm, the different experiences of donation pathways, transition from end-of-life to organ donation discussions, experiences of 'consent', paperwork and processes. Families frequently questioned if their relative wanted to have a surgery rather than supporting the person who died to save lives. CONCLUSION: Families use the unique experience of their relative dying in intensive care to create alternate narratives whereby the outcome satisfies their own utility and not necessarily those of the potential donor. New public ongoing media campaigns crafted to be more supportive of organ donation as a benefit to transplant recipients could help families overcome the many difficulties they encounter at the bedside. IMPLICATIONS FOR CLINICAL PRACTICE: The soft opt-out policy has not empowered nurses to help families at their most vulnerable to increase their support for and consent to deceased organ donation.

The dark side of climate policy uncertainty: Hindering energy transition by shaping environmental taxes effectiveness.

Climate policy uncertainty (CPU) may have an adverse impact on the environment by interfering with the effectiveness of environmental policies, but there is currently little evidence to support this indirect effect. By incorporating CPU into the transition function, this paper utilizes the panel smooth transition regression (PSTR) to dynamically analyze how CPU affects the relationship between environmental taxes (ETR) and energy transition. When CPU exceeds the threshold, the promoting effect of ETR on energy transition weakens or reverses. The robustness of the main conclusions is demonstrated by establishing a PSTR estimator with the instrumental variable. This paper also constructs a counterfactual scenario, showing that CPU reduces the positive impact of ETR on renewable energy consumption and generation by 7.6% and 3.5%, respectively. Further analysis indicates that this negative effect arises because CPU likely increases investment risk, particularly for long-term green projects, thereby inhibiting the clean energy market and energy-related green technological innovation. Heterogeneity analysis find that the weakening effect of CPU on the effectiveness of ETR is stronger in countries with low energy resource endowment, high energy intensity, and lower economic development levels, underscoring the need for tailored policy approaches. This research emphasizes that for countries with ambitious energy transition goals, climate policy stability is crucial for ensuring the healthy development of environmental taxes policy and renewable energy markets.

Anthropologies of health policy.

In this introduction to our special issue, we take a wide view of the history and epistemic stakes of anthropological and ethnographic approaches to health policy. Drawing on the history of critical medical anthropology, the anthropology of policy, and critical policy studies, we show how anthropologies of health policy are particularly essential in this current moment, as policy production becomes increasingly abstracted and even more entwined with specific forms of evidence making. Taken together, the contributors of this special issue argue that anthropology's interventions into health policy are essential in three ways. First, they shed light on the practices of policy 'communities', the pragmatic parameters under which they work, and the central logics under which health policy actors are operating. Second, they examine the effects of policy implementation upon those intended to be the subjects of health policy, highlighting the effects of policy for those marginalised by gender, race, and caste. Here, anthropology provides a view into the 'lived experience' of those targeted by health policy, but it also demands that anthropologists provide 'counter-stories' and 'counter-evidences' that dismantle narrow systems of policy knowledge production. Finally, anthropological attention provides an essential lens into the things that carry over in the act of policy reform-the past reverberations and imperial inheritances. Together with our contributors, we call for anthropologies of health policy that work to highlight and dismantle such inheritances.

Exploring the human genomic landscape: patterns of common homozygosity regions in a large middle eastern cohort.

Regions of Homozygosity (ROH) typically reflect normal demographic history of a human population, but may also relate to cryptic consanguinity, and, additionally, have been associated with specific medical conditions. The objective of this study was to investigate the location, size, and prevalence of common ROH segments in a Middle Eastern cohort. This retrospective study included 13 483 samples collected from all Chromosomal Microarray analyses (CMA) performed using Single Nucleotide Polymorphism (SNP) arrays at the genetic clinical laboratory of Rabin Medical Center between 2017-2023 (primary data set). An additional replication cohort including 100 842 samples from another SNP array platform, obtained from Maccabi Health Organization, was analyzed. Common ROH locations were defined as those ROH locations involving 1% or more of the samples. A total of 66 710 ROH segments, involving 13 035 samples (96.7%) were identified in the primary data set. Of the 4069 cytogenetic ROH locations, 68 were identified as common. The prevalence of non-common ROH was relatively high in affected individuals, and for acrocentric chromosomes, chromosomes associated with common trisomies, and non-imprinted chromosomes. In addition, differences in common ROH locations were observed between the primary and the replication cohorts. Our findings highlight the need for population-specific guidelines in determining ROH reporting cutoffs, considering factors such as population-specific prevalence and testing platform differences. Future research with larger, varied cohorts is essential to advance understanding of ROH's associations with medical conditions and to improve clinical practices accordingly.

Partnerships for policy: initiating a Global Burden of Animal Diseases case study in Indonesia.

The Global Burden of Animal Diseases (GBADs) programme aims to quantify the economic and broader societal costs of animal disease, providing information to policy-makers and other stakeholders to inform investments in animal health. Within this context, GBADs'Indonesian case study brings together a multidisciplinary and multi-national team to pilot the GBADs methodology in the Asiaâ€"Pacific region. This article describes the process of building a case study and, based on that experience, summarises key learnings to inform the development of future case studies and similar projects. Recommendations focus on the steps required to build successful partnerships to deliver a complex programme of work; the authors highlight the need to consider the local context in aligning project and country priorities, the importance of early engagement with a range of stakeholders, and the need for regular and clear communication within the project team.

Le programme " Impact mondial des maladies animales " (GBADs) vise à quantifier les coûts économiques et plus largement sociétaux des maladies animales, de manière à fournir aux décideurs politiques et aux autres parties prenantes l'information nécessaire pour étayer leurs décisions sur les investissements à réaliser en santé animale. Dans ce contexte, l'étude de cas lancée par le GBADs en Indonésie a réuni une équipe multidisciplinaire et internationale qui a eu pour tâche de piloter l'application de la méthode du GBADs dans la région Asie-Pacifique. Les auteurs décrivent le processus d'élaboration d'une étude de cas ; ils résument ensuite les principaux enseignements tirés de cette expérience, qui apporteront un éclairage précieux lors de la conception de futures études de cas et de projets similaires. Les recommandations portent principalement sur les étapes nécessaires à la mise en place de partenariats réussis et capables d'obtenir des résultats à travers un programme de travail complexe ; les auteurs soulignent ainsi la nécessité de prendre en compte le contexte local afin d'adapter les projets aux priorités du pays, l'importance de nouer des liens dès le départ avec une diversité de parties prenantes et l'exigence d'une communication claire et régulière au sein de l'équipe du projet.

El programa sobre el Impacto Global de las Enfermedades Animales (GBADs) tiene como objetivo cuantificar los costos económicos y sociales de las enfermedades animales, proporcionando información a los encargados de formular políticas y a otras partes interesadas para orientar las inversiones en sanidad animal. En este contexto, el estudio de caso del GBADs en Indonesia reúne a un equipo multidisciplinario y multinacional para poner a prueba la metodología del GBADs en la región de Asia y el Pacífico. En este artículo se describe el proceso de elaboración de un estudio de caso y, a partir de dicha experiencia, se resumen las principales enseñanzas que servirán de base para el desarrollo de futuros estudios de caso y proyectos similares. Las recomendaciones se centran en los pasos necesarios para crear alianzas fructíferas que permitan llevar adelante un programa de trabajo complejo. Los autores destacan la necesidad de tener en cuenta el contexto local a la hora de alinear las prioridades del proyecto y las del país, la importancia de establecer una pronta colaboración con diversas partes interesadas y la necesidad de que haya una comunicación regular y clara dentro del equipo del proyecto.

Changes and relevant factors in depressive and anxiety symptoms among Chinese adolescents after the "Double Reduction" policy: A repeated cross-sectional survey with a nested longitudinal subsample.

BACKGROUND: The Chinese government has enacted the "Double Reduction" Policy, which aims to reduce students' academic burden and promote their mental health, but there is limited research examining the policy's impact on students' well-being. This study aims to evaluate changes in students' mental health problems before and after the "Double Reduction" Policy and explore relevant influential factors. METHODS: A total of 101,976 elementary and junior high school students were recruited before the "Double Reduction" Policy, and 91,832 students were recruited one year later. Through data integration, a total of 36,637 students participated in both web-based surveys and provided complete data on all measures. RESULTS: As a whole, we found that the prevalence of students' depression (12.1 % to 9.2 %) and anxiety (8.9 % to 6.2 %) tended to decline after the "Double Reduction" Policy. Attending private school, reduced homework, more extracurricular activities, more time with parents, reduced academic stress, and sleep duration ≥8 h/n were associated with the decrease in the likelihood of mental health problems in students. Female gender, negative life events, and negative impact of COVID-19 as risk factors for mental health. CONCLUSIONS: These findings indicated that the "Double Reduction" Policy has improved the well-being of Chinese students. Reducing students' homework burden and alleviating their academic pressure are beneficial for their mental health. Increasing time for extracurricular activities and interaction with parents, as well as ensuring sufficient sleep for students, are also effective ways to prevent the onset and exacerbation of mental health symptoms in adolescents.

The tales of two cities: use of evidence for introducing 20 miles per hour speed limits in Edinburgh and Belfast (United Kingdom).

BACKGROUND: In 2016, large-scale 20 miles per hour speed limits were introduced in the United Kingdom cities of Edinburgh and Belfast. This paper investigates the role that scientific evidence played in the policy decisions to implement lower speed limits in the two cities. METHODS: Using a qualitative case study design, we undertook content analysis of a range of documents to explore and describe the evolution of the two schemes and the ways in which evidence informed decision-making. In total, we identified 16 documents for Edinburgh, published between 2006 and 2016, and 19 documents for Belfast, published between 2002 and 2016. FINDINGS: In both cities, evidence on speed, collisions and casualties was important for initiating discussions on large-scale 20 mph policies. However, the narrative shifted over time to the idea that 20 mph would contribute to a wider range of aspirations, none of which were firmly grounded in evidence, but may have helped to neutralize opposing discourses. DISCUSSION AND CONCLUSIONS: The relationship between evidence and decision-making in Edinburgh and Belfast was neither simple nor linear. Widening of the narrative appears to have helped to frame the idea in such a way that it had broad acceptability, without which there would have been no implementation, and probably a lot more push back from vested interests and communities than there was.

Effects of autism spectrum disorder on parents labour market: Productivity loss and policy evaluation in Kazakhstan.

LAY ABSTRACT: Kazakhstan has witnessed a significant increase in the number of Autism Spectrum Disorder cases due to the implementation of mechanisms for early detection. However, despite these efforts, accessing quality services and effective interventions for individuals with Autism Spectrum Disorder remains challenging. While the government has implemented various policies to address the impact of Autism Spectrum Disorder on the labour market, especially for those with disabilities, the effectiveness of these policies needs to be evaluated. Therefore, this article aims to estimate the loss of productivity by calculating the cost of non-working for parents of children with Autism Spectrum Disorder. To achieve this goal, we combine data from official sources with data from our own survey to estimate the loss of productivity using human capital models. In addition, we conduct policy simulations to assess the impact of the existing policy implemented in Kazakhstan that recognises the time of caring for children with Autism Spectrum Disorder and disability as working in the paid labour market. Our results reveal that the productivity loss is substantial, with mothers of children with Autism Spectrum Disorder being particularly affected. Furthermore, based on the outcomes of the policy simulations, it becomes evident that policies solely targeting parents of children with Autism Spectrum Disorder and disability are insufficient to address the labour market gaps and the consequent loss of productivity. To effectively mitigate the impact of Autism Spectrum Disorder in the labour market, a more comprehensive approach is needed. This approach should encompass a broader range of interventions and support mechanisms, including those for individuals without disabilities and parents of children with Autism Spectrum Disorder.

Allomilk: An Anthropogeny-Based Framework for Human Milk as a Climate Solution.

Climate change is an urgent threat to perinatal and infant health, with the greatest effects of climate change exposures being felt disproportionately by global majority communities who have been most harmed by systems of oppression. Human milk feeding is one recognized solution to bolster climate resilience. Yet, policies and practices to support human milk as a climate solution are inconsistent and under-prioritized, which is unsurprising given the lack of alignment between human history and current cultural context with regard to lactation and human milk access. This paper presents a new framework on lactation as a climate solution, which is unique in its incorporation of the critical history of cooperative breastfeeding in our species. Rooted in anthropogeny, or the study of human origins, and antiracist principles of lactation, the Allomilk Framework highlights five concepts of the ideal application of human milk as a climate solution, bridging ancient allonursing with present-day lactation and human milk access. These ideal applications-and the proposed development of measures to operationalize them-will advance the field through a shared understanding of the qualities that should be prioritized in the assessment of policies and practices at the intersection of climate resilience and human milk access. Application of the Allomilk Framework to assess and design future policies and practices will advance the field by increasing the potential for climate resilience and climate mitigation while working with-rather than against-the importance of cooperative breastfeeding in human history.

The evolution of evidence-based medicine.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Impact on Fatality Rates and Years of Life Lost During the COVID-19 Pandemic: The Experience of the Mexican Public Health Incident Management Command.

BACKGROUND: The SARS-CoV-2 pandemic challenged health systems worldwide. In Mexico, the Public Health Incident Management Command (COISS) strategy was implemented to improve health care for patients with COVID-19 who required hospitalization. AIM: To evaluate the impact of the COISS strategy on case fatality rates (CFR) and years of life lost (YLL) in hospitalized patients with COVID-19. MATERIALS AND METHODS: The COISS strategy included eight actions implemented in states with high epidemic risk (COISS states). A secondary analysis of the public database from the Mexican Ministry of Health was performed considering patients with confirmed diagnoses of SARS-CoV-2 infection. The COISS strategy effectiveness was evaluated by its impact on in-hospital CFR and YLL at the beginning (T0) and end (T1) of the third wave, and at the end of the fourth wave (T2) and compared to states without intervention (non-COISS states). RESULTS: At T0, COISS states showed a higher CFR for hospitalized patients than non-COISS states, which decreased after the strategy implementation. After correction for baseline conditions, lower relative CFR at T1 and T2, compared to T0, and a protective effect in different age groups, especially in those ≥65 years, were found in hospitalized patients in COISS states. The COISS strategy was associated with lower CFR in hospitalized patients with COVID-19 at both T1 and T2. At T0, YLLs were higher in COISS states, but there were no significant differences at T1 and T2. CONCLUSIONS: COISS interventions effectively reduced CFR in hospitalized patients with COVID-19, providing protection to vulnerable patients and reducing the YLL gap.

Leveraging the science of early life predictability to inform policies promoting child health.

Addressing the tremendous burden of early-life adversity requires constructive dialogues between scientists and policy makers to improve population health. Whereas dialogues focused on several aspects of early-life adversity have been initiated, discussion of an underrecognized form of adversity that has been observed across multiple contexts and cultures is only now emerging. Here we provide evidence for "why unpredictability?", including: 1. Evidence that exposures to unpredictability affect child neurodevelopment, with influences that persist into adulthood. 2. The existence of a translational non-human animal model of exposure to early life unpredictability that can be capitalized upon to causally probe neurobiological mechanisms. 3. Evidence that patterns of signals in the early environment promote brain maturation across species. 4. The uneven distribution of unpredictability across demographic populations that illuminates a possible focal point for enhancing health equity. We then outline the potential of unpredictability in terms of the "what"; that is, how might the concept of unpredictability be leveraged to inform policy? We emphasize the importance of interdisciplinary and community partnerships to the success of this work and describe our community-engaged research project. Finally, we highlight opportunities for the science of unpredictability to inform policies in areas such as screening, immigration, criminal justice, education, childcare, child welfare, employment, healthcare and housing.

"It should be hard to be a drug abuser" An evaluation of the criminalization of drug use in Sweden.

BACKGROUND: Drug use was criminalized in Sweden in 1988 with aim of reducing the number of consumers and drug-related risks and harms. Imprisonment was introduced into the penalty scale in 1993 to improve the legislation's effectiveness. The criminalization has never been evaluated. METHOD: Goal-attainment evaluation based on a range of indicators from surveys, case-finding estimates, healthcare and cause-of-death data, and crime statistics. Comparative drug policy analysis is conducted with other Nordic countries. RESULTS: The criminalization is not followed by a reduced or more expensive drug supply, reduced consumption levels, problematic drug use or healthcare needs, or to fewer drug-related deaths. Most of the indicators instead show the opposite. Control costs are high, and trends are no better than those of other Nordic countries, despite Sweden's more repressive drug policy. CONCLUSION: Criminalization emerges as an ineffective, expensive and harmful means of dealing with the drugs problem.