Differentiating busking from begging: A psychological approach.

Despite the research support that street performance is generally a beneficial element to public space, the legitimacy of street performance remains controversial. One critical issue is that busking is often confused with begging. With a psychological perspective, the present research examines the distinction of busking from begging. Two studies approached the problem from the viewpoints of street performers and passersby, respectively. Study 1 (N = 188) surveyed street performers on their reasons for street performance and reasons for why donations to street performance should be acceptable. The respondents could articulate various features of street performance along which busking could be similar to and yet distinguishable from begging. Study 2 (N = 189) experimentally compared busking and begging in how they could affect people's perception of public space. Relative to public space with begging, public space with busking was perceived as significantly more comforting, more active, less prone to crimes, and overall more likeable. These descriptive (Study 1) and experimental (Study 2) findings help to clarify the difference between busking and begging: Street performance is not merely an act of soliciting donations in public space, but it also possesses artistic and entertaining qualities that can in turn make public space more favorable. The current findings can inform the policy making and regulations of street performance. Moreover, since the present research was conducted in Hong Kong, it contributes a cultural perspective to the literature on street performance.

As relações entre o Estado e a população pobre e negra no Brasil: necropolítica tropical / The relations between the State and the poor and black population in Brazil: tropical necropolitics

O presente artigo aborda algumas diretrizes e práticas da necropolítica tropical e do racismo que opera nas relações entre o Estado e a população pobre e negra no Brasil. Notadamente, es-te trabalho interessa-se pela política mortífera executada pelas polícias, que não hesitam em matar pessoas que habitam territórios periféricos dos grandes centros urbanos do país. Sabe-se que essa relação não é nova. Ao contrário, advém dos tempos da escravidão institucional e permanece mesmo depois de 133 anos da abolição. Intentamos aqui, amparados principalmente nos trabalhos de Michel Foucault e Achille Mbembe, forjar pistas para uma espécie de ascese negra como enfrentamento à dimensão necropolítica e racista do capitalismo contemporâneo. A construção do artigo se dá na costura entre conceitos, notícias cotidianas e produções artísti-cas que investigam e evidenciam a manutenção do racismo de estado, mas também nas práticas de resistência forjadas no presente. (AU)

This article discusses some guidelines and practices of tropical necropolitics and racism that operates in relations between the State and the poor and black population in Brazil. Notably, this work is interested in the deadly policy carried out by the police, who do not hesitate to kill people who inhabit the peripheral territories. It is known that this relationship is not new. On the contrary, it comes from the institutional slavery and remains even after 133 years of abolition. We intend here, supported mainly by the works of Michel Foucault and Achille Mbembe, to forge clues to a kind of black asceticism as a confrontation with the necropolitical and racist dimension of contemporary capitalism. The construction of the article takes place in the seam between concepts, daily news and artistic productions that investigate and show the maintenance of state racism, but also in the resistance practices forged in the present. (AU)

Anticipated impacts of Brexit scenarios on UK food prices and implications for policies on poverty and health: a structured expert judgement approach.

INTRODUCTION: Food insecurity is associated with increased risk for several health conditions and with poor chronic disease management. Key determinants for household food insecurity are income and food costs. Whereas short-term household incomes are likely to remain static, increased food prices would be a significant driver of food insecurity. OBJECTIVES: To investigate food price drivers for household food security and its health consequences in the UK under scenarios of Deal and No-deal for Britain's exit from the European Union. To estimate the 5% and 95% quantiles of the projected price distributions. DESIGN: Structured expert judgement elicitation, a well-established method for quantifying uncertainty, using experts. In July 2018, each expert estimated the median, 5% and 95% quantiles of changes in price for 10 food categories under Brexit Deal and No-deal to June 2020 assuming Brexit had taken place on 29 March 2019. These were aggregated based on the accuracy and informativeness of the experts on calibration questions. PARTICIPANTS: Ten specialists with expertise in food procurement, retail, agriculture, economics, statistics and household food security. RESULTS: When combined in proportions used to calculate Consumer Price Index food basket costs, median food price change for Brexit with a Deal is expected to be +6.1% (90% credible interval -3% to +17%) and with No-deal +22.5% (90% credible interval +1% to +52%). CONCLUSIONS: The number of households experiencing food insecurity and its severity is likely to increase because of expected sizeable increases in median food prices after Brexit. Higher increases are more likely than lower rises and towards the upper limits, these would entail severe impacts. Research showing a low food budget leads to increasingly poor diet suggests that demand for health services in both the short and longer terms is likely to increase due to the effects of food insecurity on the incidence and management of diet-sensitive conditions.

Medicaid for the Plastic and Reconstructive Surgeon.

Medicaid is a complex federally and state funded health insurance program in the United States that insures an estimated 76 million individuals, approximately 20 percent of the U.S. population. Many physicians may not receive formal training or education to help understand the complexities of Medicaid. Plastic surgeons, residents, and advanced practice practitioners benefit from a basic understanding of Medicaid, eligibility requirements, reimbursement methods, and upcoming healthcare trends. Medicaid is implemented by states with certain federal guidelines. Eligibility varies from state to state (in many states it's linked to the federal poverty level), and is based on financial and nonfinancial criteria. The passage of the Affordable Care Act in 2010 permitted states to increase the federal poverty level eligibility cutoff to expand coverage for low-income adults. The aim of this review is to provide a brief history of Medicaid, explain the basics of eligibility and changes invoked by the Affordable Care Act, and describe how federal insurance programs relate to plastic surgery, both at academic institutions and in community practice environments.

Heterogeneous Impact of Supplemental Nutrition Assistance Program Benefit Changes on Food Security by Local Prices.

INTRODUCTION: The Supplemental Nutrition Assistance Program benefit amount is fixed across all 48 states (except Hawaii and Alaska), although food prices vary widely. Hence, the real value of Supplemental Nutrition Assistance Program benefits can directly affect the purchasing power of Supplemental Nutrition Assistance Program participants and subsequently their food insecurity. Using the 2 most recent changes to the Supplemental Nutrition Assistance Program benefit formula in 2009 and 2013, this study examines whether the changes in benefit level affected food security of participants differentially depending on local food prices. METHODS: Data from the Current Population Survey-Food Security Supplement 2008-2009 and 2012-2013, merged with the Regional Price Parities from the Bureau of Economic Analysis, were used. Linear regression with a differences-in-differences strategy estimated the effects of Supplemental Nutrition Assistance Program benefit changes on the food security of Supplemental Nutrition Assistance Program households, separately by those in high- and low-cost areas. The analyses were completed in 2019. RESULTS: After the benefit increase, the prevalence of low food security among Supplemental Nutrition Assistance Program households living in high-cost areas declined by 11.2 percentage points (95% CI=1.6, 20.8). Following the benefit decrease, the prevalence of very low food security among Supplemental Nutrition Assistance Program households increased by 8.7 percentage points (95% CI=3.6, 13.8) in high-cost areas. In contrast, there was no statistically significant difference between Supplemental Nutrition Assistance Program and non-Supplemental Nutrition Assistance Program households in low-cost areas in response to the benefit changes. CONCLUSIONS: Given the heterogeneous effects of the Supplemental Nutrition Assistance Program benefit changes on food security by local food prices, this study provides additional evidence for the ongoing policy debate regarding whether the Supplemental Nutrition Assistance Program benefit amounts should be adjusted to the cost of living.

The role of psychology in evidence-based policymaking: Mapping opportunities for strategic investment in poverty reduction.

Increasing efforts are being undertaken to understand how to improve the use of research evidence in policy settings. In particular, growing efforts to understand the use of research in legislative contexts. Although high-profile examples of psychology's contributions to public policy exist-particularly around antipoverty legislation-little systematic review has quantified how the field has informed federal policy across time. Recognizing the importance of exploring psychology's use in policymaking, we provide an overview of psychology's presence in federal antipoverty legislation over the last 2 decades by reviewing the over 6,000 antipoverty bills introduced to the U.S. Congress since 1993 for mentions of psychology. Further, to explore how psychology's contributions are related to policymakers' attributions about the causes of poverty, their public statements and voting behavior is considered. Key gaps in our scientific knowledge for informing poverty-related policy are identified. Opportunities to enhance the relevance of psychology in poverty reduction efforts, including the evidence-based policy movement, are described. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Pobreza, proteção social e cidadania: uma análise do direito à saúde no Brasil a partir da Constituição Federal de 1988 / Poverty, social protection and citizenship: an analysis of the right to health in Brazil from the Federal Constitution of 1988

O presente artigo teve por escopo analisar o processo de constituição da ideia do direito à saúde enquanto direito social no Brasil, integrante do rol de direitos fundamentais insculpidos na Constituição Federal de 1988. Para tanto realizou-se uma concisairrupção histórica no processo de construção da concepção de proteção social na Europa ocidental. Objetivou-se, ainda, analisar a proteção social enquanto elemento essencial da cidadania. Buscou-se compreender a seguridade social como núcleo do Estado de Bem-Estar e discutir o contexto de inserção da questão do direito à saúde na agenda pública. A presente pesquisa utilizou-se dométodo de pesquisa dedutivo, com a apropriação dos conceitos de proteção social e direitos sociais, refletindo sobre as determinações dos conteúdos presentes na concepção constitucional do direito à saúde.(AU)

The purpose of this article was to analyze the process of constitution of the idea of the right to health as a social right in Brazil, as part of the list of fundamental rights inscribed in the Federal Constitution of 1988. For this purpose, a concise historical irruption was made in the process of conception of social protection in western Europe. The objective was also to analyze social protection as an essential element of citizenship. We sought to understand social security as the core of the welfare state and to discuss the context of insertion of the right to health issue in the public agenda. This research used the deductive research method, with the appropriation of the concepts of social protection and social rights, reflecting on the determinations of the contents present in the constitutional conception of the right to health.(AU)

Best Practices and Innovative Solutions to Overcome Barriers to Delivering Policy, Systems and Environmental Changes in Rural Communities.

To better understand the barriers to implementing policy; systems; and environmental (PSE) change initiatives within Supplemental Nutrition Assistance Program-Education (SNAP-Ed) programming in U.S. rural communities; as well as strategies to overcome these barriers, this study identifies: (1) the types of nutrition-related PSE SNAP-Ed programming currently being implemented in rural communities; (2) barriers to implementing PSE in rural communities; and (3) common best practices and innovative solutions to overcoming SNAP-Ed PSE implementation barriers. This mixed-methods study included online surveys and interviews across fifteen states. Participants were eligible if they: (1) were SNAP-Ed staff that were intimately aware of facilitators and barriers to implementing programs, (2) implemented at least 50% of their programming in rural communities, and (3) worked in their role for at least 12 months. Sixty-five staff completed the online survey and 27 participated in interviews. Barriers to PSE included obtaining community buy-in, the need for relationship building, and PSE education. Facilitators included finding community champions; identifying early "wins" so that community members could easily see PSE benefits. Partnerships between SNAP-Ed programs and non-SNAP-Ed organizations are essential to implementing PSE. SNAP-Ed staff should get buy-in from local leaders before implementing PSE. Technical assistance for rural SNAP-Ed programs would be helpful in promoting PSE.

Association of the Affordable Care Act's Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure.

BACKGROUND: Heart failure (HF) is the leading cause of morbidity and mortality in the United States. Despite advancement in the management of HF, outcomes remain suboptimal, particularly among the uninsured. In 2014, the Affordable Care Act expanded Medicaid eligibility, and millions of low-income adults gained insurance. Little is known about Medicaid expansion's effect on inpatient HF care. METHODS AND RESULTS: We used the American Heart Association's Get With The Guidelines-Heart Failure registry to assess changes in inpatient care quality and outcomes among low-income patients (<65 years old) hospitalized for HF after Medicaid expansion, in expansion, and nonexpansion states. Patients were classified as low-income if covered by Medicaid, uninsured, or missing insurance. Expansion states were those that implemented expansion in 2014. Piecewise logistic multivariable regression models were constructed to track quarterly trends of quality and outcome measures in the pre (January 1, 2010-December 31, 2013) and postexpansion (January 1, 2014-June 30, 2017) periods. These measures were compared between expansion versus nonexpansion states during the postexpansion period. The cohort included 58 804 patients hospitalized across 391 sites. In states that expanded Medicaid, uninsured HF hospitalizations declined from 7.9% to 4.4%, and Medicaid HF hospitalizations increased from 18.3% to 34.6%. Defect-free HF care was increasing during the preexpansion period (adjusted odds ratio/quarter, 1.06; 95% confidence interval, 1.03-1.08) but did not change after expansion (adjusted odds ratio, 0.99; 95% confidence interval, 0.97-1.02). Patterns were similar for other quality measures. There were no quality measures for which the rate of improvement sped up after expansion. In-hospital mortality rates remained similar during the preexpansion (adjusted odds ratio, 0.99; 95% confidence interval, 0.96-1.02) and postexpansion periods (adjusted odds ratio, 1.00; 95% confidence interval, 0.97-1.03). Among nonexpansion states, uninsured HF hospitalizations increased (11.6% to 16.7%) as did Medicaid HF hospitalizations (17.9% to 26.6%), and no quarterly improvement was observed for most quality measures in the post compared with preexpansion period. During the postexpansion period, defect-free care and mortality did not differ between expansion and nonexpansion states. CONCLUSIONS: Medicaid expansion was associated with a significant decline in uninsured HF hospitalizations but not improvements in quality of care or in-hospital mortality among sites participating in a national quality improvement initiative. Efforts beyond insurance expansion are needed to improve in-hospital outcomes for low-income patients with HF.

Comparison of Sampling Strategies for Tobacco Retailer Inspections to Maximize Coverage in Vulnerable Areas and Minimize Cost.

Introduction: In the United States, tens of thousands of inspections of tobacco retailers are conducted each year. Various sampling choices can reduce travel costs, emphasize enforcement in areas with greater noncompliance, and allow for comparability between states and over time. We sought to develop a model sampling strategy for state tobacco retailer inspections. Methods: Using a 2014 list of 10,161 North Carolina tobacco retailers, we compared results from simple random sampling; stratified, clustered at the ZIP code sampling; and, stratified, clustered at the census tract sampling. We conducted a simulation of repeated sampling and compared approaches for their comparative level of precision, coverage, and retailer dispersion. Results: While maintaining an adequate design effect and statistical precision appropriate for a public health enforcement program, both stratified, clustered ZIP- and tract-based approaches were feasible. Both ZIP and tract strategies yielded improvements over simple random sampling, with relative improvements, respectively, of average distance between retailers (reduced 5.0% and 1.9%), percent Black residents in sampled neighborhoods (increased 17.2% and 32.6%), percent Hispanic residents in sampled neighborhoods (reduced 2.2% and increased 18.3%), percentage of sampled retailers located near schools (increased 61.3% and 37.5%), and poverty rate in sampled neighborhoods (increased 14.0% and 38.2%). Conclusions: States can make retailer inspections more efficient and targeted with stratified, clustered sampling. Use of statistically appropriate sampling strategies like these should be considered by states, researchers, and the Food and Drug Administration to improve program impact and allow for comparisons over time and across states. Implications: The authors present a model tobacco retailer sampling strategy for promoting compliance and reducing costs that could be used by US states and the Food and Drug Administration (FDA). The design is feasible to implement in North Carolina. Use of the sampling design would help document the impact of FDA's compliance and enforcement program, save money, and emphasize inspections in areas where they are needed most. FDA should consider requiring probability-based sampling in their inspections contracts with states and private contractors.

Forensic Experts, Indigent Defendants, and the Constitution.

Over 30 years ago, the U.S. Supreme Court held that indigent defendants raising psychiatric issues are entitled to the assistance of a mental health expert. However, the exact dimensions of that assistance, and whether the expert must be assigned exclusively to assist the defense, have been in contention ever since. In its recent decision in McWilliams v. Dunn, the Court underscored that the state-funded expert must be available to consult with the defense, not merely to evaluate the defendant, but declined to opine on whether the defense is entitled to its own expert for the purpose.

The Barriers to Achieve Financial Protection in Iranian Health System: A Qualitative Study in a Developing Country.

BACKGROUND: The move to universal health coverage and consequently health promotion is influenced by political, socio-economic and other contextual factors in a country. Iran, as a developing country with an upper-middle national income, has developed policies to achieve universal health coverage through financial protection. This study aims to investigate barriers to develop financial protection as a requirement to achieve universal health coverage. MATERIALS AND METHODS: This qualitative study was conducted using 20 in-depth interviews with experts in social welfare, health insurance and financing. The framework analysis method was used to analyze the data. RESULTS: The results have been categorized in three major themes that were extracted from ten sub-themes. The major themes included the political, social and economic context of the country, the context and structure of healthcare system and dimensions of UHC. CONCLUSION: Achieving financial protection as a long-term objective should be considered as a priority among Iranian policy makers that requires an inter-sectoral collaboration with a defined in-charge body. Health policy makers in Iran should develop a more comprehensive benefits package for diseases and health conditions with catastrophic consequences. They also should develop a plan to cover the poor people.

Improving nutrition-sensitivity of social protection programmes in Ghana.

Social protection (SP) has been demonstrated as an effective tool against poverty and severe hunger. In Ghana, SP interventions have been employed to address vulnerability to poverty since 1965. Nevertheless, its potential for enhancing nutrition has hardly been explored. To harness the cross-sectoral benefits of scaling up nutrition-sensitive actions in Ghana, the national development planning commission requested an assessment of nutrition linkages across existing SP policies and programmes. The present paper presents gaps and opportunities for improving nutrition-sensitivity of existing SP programming in Ghana. The evidence draws heavily on desk review of available published and grey literature. The data show that SP provides an entry point for mainstreaming nutrition into other programmes. However, designing and coupling SP programmes with nutrition programmes remain a challenge in Ghana. Local SP interventions are predominantly designed as standalone services and therefore are implemented independent of each other. To increase synergy between SP and nutrition, including nutrition as an explicit objective of SP policies/strategies is recommended.

Lunatic Asylum in the Workhouse: St Peter's Hospital, Bristol, 1698-1861.

In recent years there has been growing acknowledgement of the place of workhouses within the range of institutional provision for mentally disordered people in nineteenth-century England. This article explores the situation in Bristol, where an entrenched workhouse-based model was retained for an extended period in the face of mounting external ideological and political pressures to provide a proper lunatic asylum. It signified a contest between the modernising, reformist inclinations of central state agencies and local bodies seeking to retain their freedom of action. The conflict exposed contrasting conceptions regarding the nature of services to which the insane poor were entitled. Bristol pioneered establishment of a central workhouse under the old Poor Law; 'St Peter's Hospital' was opened in 1698. As a multi-purpose welfare institution its clientele included 'lunatics' and 'idiots', for whom there was specific accommodation from before the 1760s. Despite an unhealthy city centre location and crowded, dilapidated buildings, the enterprising Bristol authorities secured St Peter's Hospital's designation as a county lunatic asylum in 1823. Its many deficiencies brought condemnation in the national survey of provision for the insane in 1844. In the period following the key lunacy legislation of 1845, the Home Office and Commissioners in Lunacy demanded the replacement of the putative lunatic asylum within Bristol's workhouse by a new borough asylum outside the city. The Bristol authorities resisted stoutly for several years, but were eventually forced to succumb and adopt the prescribed model of institutional care for the pauper insane.