Social Decision-Making Analysis: A General Approach to Inform Decisions on Resources in the Public Sector.

OBJECTIVES: Public expenditure aims to achieve social objectives by improving a range of socially valuable attributes of benefit (arguments in a social welfare function). Public expenditure is typically allocated to public sector budgets, where budget holders are tasked with meeting a subset of social objectives. METHODS: Decision makers require an evidence-based assessment of whether a proposed investment is likely to be worthwhile given existing levels of public expenditure. However, others also require some assessment of whether the overall level and allocation of public expenditure are appropriate. This article proposes a more general theoretical framework for economic evaluation that addresses both these questions. RESULTS: Using a stylized example of the economic evaluation of a new intervention in a simplified UK context, we show that this more general framework can support decisions beyond the approval or rejection of single projects. It shows that broader considerations about the level and allocation of public expenditure are possible and necessary when evaluating specific investments, which requires evidence of the range of benefits offered by marginal changes in different types of public expenditure and normative choices of how the attributes of benefit gained and forgone are valued. CONCLUSIONS: The proposed framework shows how to assess the value of a proposed investment and whether and how the overall level of public expenditure and its allocation across public sector budgets might be changed. It highlights that cost-benefit analysis and cost-effectiveness analysis can be viewed as special cases of this framework, identifying the weakness with each.

Social fund and infant mortality: Evidence from an anti-poverty policy in Northeast Brazil.

This paper evaluates the effects of a social fund that meets the needs of the poor in Northeast Brazil, the Fundos Estaduais de Combate e Erradicação da Pobreza (FECEP). The program could have improved infant health by reducing poverty and improving access to health care, sanitation, food, and housing. Using a difference-in-differences approach robust to heterogeneous treatment effects, we confirm that the program has effectively reduced poverty in treated areas. Furthermore, we document that this poverty reduction is associated with a significant decline in infant mortality. These findings provide consistent evidence that targeted public investments can improve living conditions in vulnerable regions.

When the economy falters, hearts suffer: Economic recessions as a social determinant of health in cardiovascular emergencies.

INTRODUCTION: While the relationships between cardiovascular disease (CVD), stress, and financial strain are well studied, the association between recessionary periods and macroeconomic conditions on incidence of disease-specific CVD emergency department (ED) visits is not well established. OBJECTIVES: This retrospective observational study aimed to assess the relationship between macroeconomic trends and CVD ED visits. METHODS: This study uses data from the National Hospital Ambulatory Care Survey (NHAMCS), Federal Reserve Economic Database (FRED), National Bureau of Economic Research (NBER), and CVD groupings from National Vital Statistics (NVS) and Center for Medicare and Medicaid Services (CMS) from 1999 to 2020 to analyze ED visits in relation to macroeconomic indicators and NBER defined recessions and expansions. RESULTS: CVD ED visits grew by 79.7% from 1999 to 2020, significantly more than total ED visits (27.8%, p < 0.001). A national estimate of 213.2 million CVD ED visits, with 22.9 million visits in economic recessions were analyzed. A secondary group including a 6-month period before and after each recession (defined as a "broadened recession") was also analyzed to account for potential leading and lagging effects of the recession, with a total of 50.0 million visits. A significantly higher proportion of CVD ED visits related to heart failure (HF) and other acute ischemic heart diseases (IHD) was observed during recessionary time periods both directly and with a 6-month lead and lag (p < 0.05). The proportion of aortic aneurysm and dissection (AAA) and atherosclerosis (ASVD) ED visits was significantly higher (p = 0.024) in the recession period with a 6-month lead and lag. When controlled for common demographic factors, economic approximations of recession such as the CPI, federal funds rate, and real disposable income were significantly associated with increased CVD ED visits. CONCLUSION: Macroeconomic trends have a significant relationship with the overall mix of CVD ED visits and represent an understudied social determinant of health.

The nexus of immigration regulation and health governance: a scoping review of the extent to which right to access healthcare by migrants, refugees and asylum seekers was upheld in the United Kingdom during COVID-19.

OBJECTIVES: Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic. STUDY DESIGN: Arksey and O'Malley's scoping review framework. METHODS: A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach. RESULTS: Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner. CONCLUSIONS: An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of 'leaving no one behind' in post-pandemic and future responses.

Knowledge of the Stress-Health Link as a Source of Resilience Among Mexicans in the Arizona Borderlands.

Mexicans who migrate to the United States endure significant stressors related to the migration process and social and environmental conditions of life in the United States. Given that chronic stress exposure has been linked to the onset of health conditions, these ecological factors may expose them to increased risk for poor health. However, Mexicans have many positive health outcomes compared to those monitored nationally, making it crucial to understand possible sources of resilience in this population. Here, we investigate Mexicans' lay health knowledge in response to stress as a possible source of health-related resilience. Health knowledge is considered a central facet of practical and traditional knowledge as well as adaptive modes of intelligence and has a tangible impact on health. Using an ethnographically grounded community-based participatory research design informed by the theory of embodiment, our hybrid team of bilingual university and community-based researchers interviewed Mexican-origin residents (N = 30) living in rural southwestern Arizona about how they experienced and responded to stress and incorporated it into their etiological frameworks. Thematic analysis revealed that participants paid close attention to how stress presented itself in their bodies, which informed their understanding of its potentially harmful health impacts and motivated them to employ multiple stress reduction strategies. Our results highlight the breadth of Mexicans' lay health knowledge, thereby challenging dominant narratives about low rates of health literacy in this population. Findings can be harnessed to optimize potential health protective effects in home and community settings as well as to inform preventive and clinical interventions.

Private equity firms and industrial policy: elaborating the state-finance nexus in state-led markets.

Under what conditions can the state discipline private equity firms into delivering the investment required to meet the coming needs of industrial transformation? States have sought to crowd in private capital to finance industrial development, but the results have so far been less than satisfactory. Prevailing accounts of financial industry power largely characterise an arms-length state-finance relationship that has unfolded in private-led markets where private equity firms have contributed to the secular growth in non-productive economic activity. This article problematises the assumption of private-led markets and argues that state-led markets present a counterfactual in which the disbursement of public money entails strict policy discipline and tight embedding between the state and private equity firms, which provides the conditions for them to emerge as unlikely champions of industrial policy. Two cases of co-investment between Chinese and European sovereign wealth funds demonstrate the power dynamics at play. Where PE firms in the Sino-Irish co-investment facilitated the international scaling of Irish firms in China, the PE firms operating in Europe failed to embed Chinese firms into regional supply chains in the Sino-Belgian co-investment.

Pension funds and fossil fuel phase-out: historical developments and limitations of pension climate strategies.

Despite the decades of international climate negotiations and several landmark agreements, global efforts to date to restrict fossil fuel production in line with climate targets have been unsuccessful. As national and international policies continue to fall short of phasing out fossil fuels, increasing attention has been paid to non-state actors, like pension funds, as a potential source of more ambitious climate action. As major asset owners, large shareholders in fossil fuel companies, and historically activist investors, pension funds are theoretically well-placed to contribute to phasing out fossil fuels. Despite growing recognition of this potential role for pension funds and other major investors in climate change mitigation, there has been little attention to pension funds' historical record on climate change, or to how their climate strategies have developed and changed over time. This paper examines how the climate strategies of the largest US and European pension funds have evolved in relation to key developments in international climate agreements and the extent to which these strategies contribute to restricting fossil fuel supply. Through an analysis of the annual, governance, and sustainability reports of 6 pension funds from 1997 to 2022, we examine the strategies pension funds have adopted to address both climate change and fossil fuels. Pension funds have demonstrated responsiveness to the signals of international climate agreements, adopting a range of strategies with respect to climate change (amongst others, integrating ESG principles, increasing their sustainable investments, and setting net zero goals). Their explicit attention to fossil fuels and contribution to supply-side interventions take the form of systematic shareholder engagement, (selective) divestment, and lobbying policymakers. While pension fund climate action is growing , the ambition of their strategies is not aligned with a rapid fossil fuel phaseout; their efforts are often focussed on improving disclosure and transparency and demonstrate complacency with minimal improvements from fossil fuel companies. If pension funds are to significantly contribute to phasing out fossil fuels, redefining pension fund responsibilities and the traditional shareholder role will likely be required.

Influence of Basic Health Care Provision Fund in improving primary Health Care in Kano state, a descriptive cross-sectional study.

BACKGROUND: The Basic Health Care Provision Fund (BHCPF) is a direct financial investment that funds Primary Healthcare (PHC) to improve the quality of services. This study assessed the influence of the BHCPF in improving PHC services. METHODS: A descriptive cross-sectional study was conducted among PHC workers in 100 facilities randomly selected from the 484 designated PHCs for implementing the BHCPF project in Kano state. Using multiple sampling methods, 200 healthcare workers in PHC facilities were selected and assisted by trained data collectors to respond to the questionnaires. Chi-square analysis was used to show associated factors, while binary regression analysis was used to determine the relationship between factors influencing the BHCPF implementation in PHC. RESULT: The findings showed healthcare workers had higher awareness (61.7%) and good utilization (57.1%) of BHCPF. Challenges of the BHCPF implementation were insufficiently skilled health professionals (85%), lack of data management capacity (52.6%), low community participation and awareness (52.0%), delay in releasing funds (60.7%), poor infrastructure (87.8%), and weak financial management and accountability system (58.2%). Healthcare professionals having a diploma were four times more likely to have the National Health Management Information System (NHMIS) in their facilities (AOR = 4.955, 95% CI = 1.120-21.036; P-value 0.035) than those without. Primary healthcare facilities were two times more likely to have the NHMIS (AOR = 2.549, 95% CI = 1.167-5.566: P-value 0. 019) than health post. CONCLUSION: The factors that influenced PHC facilities to promote the implementation of BHCPF included: periodic evaluation of the facilities, availability of functional storage facilities, and improving the standard of care in PHC facilities. There is a need for retraining healthcare workers and creating more community awareness of the BHCPF.

Invisible social Europe? Linking citizens' awareness of European cohesion funds, individual power resources, and support for the EU.

In the twentieth century national social policies stabilized the European state systems, favouring domestic concordance and citizens' support to the nation-building process. Welfare institutions have historically served this key political function also in federal systems, where social citizenship has been used as a tool to foster unity. In contrast, even though the EU devotes a consistent part of its (however limited) budget to social cohesion and inclusion programmes, it takes little credit for such efforts. Building on original survey data on public opinion collected in 2019 across ten EU countries, this article shows that, indeed, only a limited number of citizens are aware of the social role played by the EU in their local community. On the other hand, it demonstrates that citizens' awareness of EU programmes strengthens the individual perception of power resources stemming from euro-social initiatives, the feeling of 'being heard' by the EU and, ultimately, the support for the European integration project as a whole. By implication, increasing the relevance and visibility of euro-social programmes could possibly reinforce the very foundations of the EU.

The impact of financial tools in environmental degradation management: the relationship between Co2 emission and ESG funds.

This study aims to determine whether ESG funds can be used as an effective tool for environmental sustainability. ESG funds, which first appeared in the 2000s and were exported by environmentally friendly companies, are among the most effective tools for increasing firm value and managing environmental degradation. The causality relationship between the ESG funds, one of the environmentally friendly investment instruments, and the CO2 emission values, which are used as an environmental degradation criterion, was investigated in this study. The study used 209 daily data sets from July 31, 2020, to May 28, 2021. The symmetric developed by Hacker and Hatemi-J (Appl Econ 38:1489-1500, 2006), the asymmetric developed by Hatemi-J (Empir Econ 43:447-456, 2012), and time-varying asymmetric causality tests were used as models. According to the study results, while there is no symmetric causality between CO2 emissions and ESG funds, there is causality between CO2 emissions and ESG funds prices for negative shocks and between CO2 emissions and ESG funds trade volume for positive shocks. The results of a time-varying asymmetric causality test also support that this causality relationship varies by period. As a result, ESG funds can be used as a strategic financial tool to improve environmental quality during the COVID-19 period; however, this may vary for different sub-sample periods.

The response of money market funds to the COVID-19 pandemic.

The Covid-19 Pandemic has increased the attention paid to money market funds. Using Covid-19 cases and a measure of lockdowns, shutdowns, etc., we analyze if money market fund investors and managers responded to the intensity of the pandemic. We ask whether or not the Federal Reserve implementation of the Money Market Mutual Fund Liquidity Facility (MMLF) had an effect on market participant behavior. We find that institutional prime investors responded significantly to the MMLF. Fund managers responded to the intensity of the pandemic but largely ignored the reduction in uncertainty created by the implementation of the MMLF.

Covid-19 vaccines and investment performance: Evidence from equity funds in European Union.

In this paper, we analyze the impact of the marketing authorization of EMA-approved vaccines on the returns of equity funds in the EU. Using the event study methodology, we report that the introduction of all vaccines had a positive impact on the funds' returns. Higher abnormal returns were associated with the earlier vaccines, indicating the first-mover advantage and the abnormal returns were persistent across several event windows. The findings imply that equity markets welcomed the vaccine administration as an important pharmaceutical intervention to support the quasi-revival of business activities. Consequently, there was a significant uplift in the economic bottom line.

What is the potential of compensation funds for addressing COVID-related personal injury?

The COVID-19 pandemic continues to present new challenges at the frontiers of social risk. Its significant societal impact has prompted the consideration of alternative frameworks like compensation funds to better allocate the risks and impacts of COVID-related injury. Although there has been discussion about the potential of alternative liability structures for vaccine-related injury, there has been less analysis of the right way to compensate other types of injury, such as long-term illness, disability and death, associated with the SARS-CoV-2 virus. In France, a universal compensation fund for COVID-19-related injuries, designed similarly to asbestos-related schemes, was considered by the parliament. With an eye on scientific knowledge of the best practice in the development and operation of compensation frameworks, this paper analyses the design of such funds in Europe as applied to COVID-19 injury and considers the position of compensation funds in relation to tort law, private insurance and social security models.

Communities and regularities in the behavior of investment fund managers.

We analyze a large microlevel dataset on the full daily portfolio holdings and exposures of 22 complex investment funds to shed light on the behavior of professional investment fund managers. We introduce a set of quantitative attributes that capture essential distinctive features of manager allocation strategies and behaviors. These characteristics include turnover, attitude toward hedging, portfolio concentration, and reaction to external events, such as changes in market conditions and flows of funds. We find the existence and stability of three main investment attitude profiles: conservative, reactive, and proactive. The conservative profile shows low turnover and resilience against external shocks; the reactive one is more prone to respond to market condition changes; and members of the proactive profile frequently adjust their portfolio allocations, but their behavior is less affected by market conditions. We find that exogenous shocks temporarily alter this configuration, but communities return to their original state once these external shocks have been absorbed and their effects vanish.

Ecuadorian water funds' use of scale-sensitive strategies to stay on course in forest and landscape restoration governance.

Water funds are task-specific organisations that conserve and restore watersheds. The funds provide sustained finance and a collaborative space for actors at different levels to improve the water regulation functions of upstream ecosystems, safeguard water quality, and establish ecological connectivity with the aim of ensuring downstream water quantity and quality. However, while implementing conservation and restoration efforts at local level, water funds encounter scale challenges, consisting of mismatches between the ecological and the governance scale and misalignment between governance levels. This study's aim is to identify and unravel both the scale challenges with which two Ecuadorian water funds (FONAG and FORAGUA) were confronted and the scale-sensitive governance strategies that they planned and deployed to overcome them. We collected data through a document review, 48 semi-structured interviews, and participatory observation, and used content analysis methods to analyse the interview transcripts. Consequently, at both funds, we identified a blind spot towards rural livelihood realities, a temporal mismatch between short-term election cycles and long-term restoration timelines, and a spatial mismatch between the reach of restoration efforts and degradation processes. At FORAGUA, we also identified heterogeneity across levels regarding the purpose of restoration, with different spatial implications. We identified a total of 12 tailored strategies that the two water funds deployed or aim to deploy in reaction to these challenges in an attempt to re-create fit with ecological processes and alignment with other governance levels. Some of these strategies caused new scale challenges to emerge. By observing and acting on emerging scale challenges, water funds try to stay on course to achieve restoration objectives. We conclude that the water funds, which are governance arrangements designed to create spatial and temporal fit with ecological processes, have to continuously adapt their governance strategies to maintain cross-scale fit and cross-level alignment.

[Epidemiology of scabies in Germany: multisource analysis of primary and secondary data]. / Epidemiologie der Skabies in Deutschland: Multi-Source-Analyse von Primär- und Sekundärdaten.

BACKGROUND: Scabies is one of the most common and, in terms of burden of disease, one of the most significant skin diseases worldwide. In Germany, an increase in cases is currently being discussed, for which reliable data have been lacking until now. OBJECTIVES: The goal is to clarify the prevalence and treatment of scabies in Germany. MATERIALS AND METHODS: Multisource analyses of treatment data from a nationwide statutory health insurance company, the Federal Statistical Office and company skin screenings. RESULTS: In Germany, the number of cases of scabies has been rising since 2009 and especially since 2014. In the outpatient setting, there was an increase of 52.8% to around 128,000 treatment cases between 2010 and 2015. Currently, more than 11,000 inpatient cases are documented annually in Germany with scabies as the main diagnosis (ICD-10 B86). The increase between 2010 and 2016 was about 306%. The main outpatient specialist groups providing care are dermatologists and general practitioners, while in the inpatient sector treatment is provided by departments of dermatology, paediatrics and internal medicine. CONCLUSION: Due to the aforementioned development of prevalence and incidence, the need for care will remain at a high level in the future, which suggests an increased need for education and early detection.

Luxembourg and Ireland in global financial networks: Analysing the changing structure of European investment funds.

Using a unique database on investment funds and the conceptual framework of global financial networks, this paper examines the spatial structure of the European investment fund industry, with particular focus on Luxembourg and Ireland. Grounded in financial and economic geography, the paper shows how these countries became the leading investment fund domiciles through a mixture of structural factors and agency enabling a fast and flexible implementation of the European Directive on the Undertakings for the Collective Investment in Transferable Securities (UCITS) of 1985, and the cultivation of the investment fund industry ever since. In the process, Luxembourg and Ireland have built on and developed their functions as offshore jurisdictions and international financial centres, both sustained by their governments and regulatory agencies. The analysis of the functional structure of investment funds and their networked geography reveals the increasingly dominant position of London as the investment management centre for the industry, and the increasing concentration of control by large asset management firms. Stripped to its basics, the geography of European investment fund networks is about large, mainly US, asset management firms, creating and managing funds in Luxembourg and Ireland, and investing money through London. As such, the rise of European investment funds can be seen as an example of European financial integration through Americanisation. The Luxembourg and Irish investment fund industry are connected mainly through London and New York, and thus function as satellites of the NY-LON axis, rather than a Luxembourg-Dublin axis in international finance. Overall, the paper demonstrates that studying this seemingly arcane industry, and the role of two small countries in it, reveals much about the nature of financial globalisation.

The European structural and investment funds and public investment in the EU countries.

Public investment is low and has declined in many EU countries since the global financial crisis. This paper estimates the effects of the various European Structural and Investment Funds (ESIF) on public investment in the EU countries. The analysis is run on annual data from 2000 to 2018 using dynamic panel data specifications. Funding from the Cohesion Fund, the EU's facility for its less developed members, has had an almost one-to-one effect on public investment in the short term, and more in the longer term. Funding from the European Regional Development Fund may have had some effect, but it cannot be estimated precisely. Funding from other ESIF funds does not seem to have been related to public investment in the EU countries.

Latina Mothers' Cultural Experiences, Beliefs, and Attitudes May Influence Children's Math Learning.

Drawing from a qualitative approach and through individual pláticas (processes of co-constructing knowledge through dialogue) as a linguistic and cultural framework, this work explored informal contextual factors valued by Spanish-speaking Latina mothers of children, three to five years of age and enrolled in a nonprofit California preschool. Results revealed that Latina mothers have cultural forms of knowledge which impact their children's educational experiences and engage in direct and indirect numeracy environments. While personal math experiences and home practices differed, Latina mothers experience and navigate their children's learning based on sociocultural aspects, influencing how they support their children's math learning. This study drew from sociocultural learning theories that value learning embedded within meaningful learning experiences. Patterns of family learning have several implications for educational practice, especially for Latine families whose parent participation is typically not as visible as White American English-speaking parents.

Perks and Perils of Strategic Choice: South Korea's Iran Policy Under Moon Jae-in.

After some two decades of growing partnership between Seoul and Tehran, South Korea's bilateral relationship with Iran reached a bottom of absolute gloom under the leadership of Moon Jae-in. Most of his presidency coincided with the administration of Donald Trump who followed a relatively contrasting approach toward the North Korean and Iranian nuclear issues. Washington's Pyongyang and Tehran policies were naturally bound to create opportunities as well as troubles for the Moon-led Korean government's dealing with North Korea and Iran. Arguing from a perspective of strategic choice, this study asserts that Moon almost forfeited the ROK's commercial interests in Iran for the sake of advancing his North Korean agenda. As a corollary, the South Korean-Iranian ties sank to an all-time low, culminating in unprecedented diplomatic tensions between the two countries over the issue of Iran's oil incomes frozen in Seoul. The Mideast country's subsequent resort to gunboat diplomacy by seizing a Korean oil tanker in the Persian Gulf did also little to break the gridlock over the dilemma of blocked assets because any satisfactory and lasting solution regarding this intractable trouble largely hinged on resolving the fate of Iran's nuclear deal between Tehran and Washington.