scholarly journals The Impact of Heterogeneous Management Interests in Reducing Social Losses from Wildfire Externalities

Forests ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1326
Author(s):  
Ibtisam Al Abri ◽  
Kelly Grogan

The United States has experienced an even longer and more intense wildfire season than normal in recent years, largely resulting from drought conditions and a buildup of flammable vegetation. The derived stochastic dynamic model in this study was utilized to evaluate the interaction of wildfire risk mitigation policies for two adjacent landowners under various scenarios of forest benefits while accounting for full awareness of fire externalities. This study also evaluated the effectiveness of cost-share programs and fuel stock regulation and investigated under which scenarios of forest management interests the implementation of these policies encourages risk mitigation behaviors and yields larger reductions in social costs. The findings revealed that social costs significantly reduced after the implementation of cost-share programs and fuel stock regulation. Market-oriented adjacent landowners were more responsive to policy instruments compared to other types of neighboring landowners, and their responsiveness was greater for fuel stock regulation policies than for cost-share programs. Policymakers may introduce extra financial incentives or more rigorous fuel stock regulations to induce nonmarket-oriented landowners to undertake increased fuel management activities.

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260055
Author(s):  
Rachel L. Snyder ◽  
Laura E. Anderson ◽  
Katelyn A. White ◽  
Stephanie Tavitian ◽  
Lucy V. Fike ◽  
...  

Background A large portion of COVID-19 cases and deaths in the United States have occurred in nursing homes; however, current literature including the frontline perspective of staff working in nursing homes is limited. The objective of this qualitative assessment was to better understand what individual and facility level factors may have contributed to the impact of COVID-19 on Certified Nursing Assistants (CNAs) and Environmental Services (EVS) staff working in nursing homes. Methods Based on a simple random sample from the National Healthcare Safety Network (NHSN), 7,520 facilities were emailed invitations requesting one CNA and/or one EVS staff member for participation in a voluntary focus group over Zoom. Facility characteristics were obtained via NHSN and publicly available sources; participant demographics were collected via SurveyMonkey during registration and polling during focus groups. Qualitative information was coded using NVIVO and Excel. Results Throughout April 2021, 23 focus groups including 110 participants from 84 facilities were conducted homogenous by participant role. Staffing problems were a recurring theme reported. Participants often cited the toll the pandemic took on their emotional well-being, describing increased stress, responsibilities, and time needed to complete their jobs. The lack of consistent and systematic guidance resulting in frequently changing infection prevention protocols was also reported across focus groups. Conclusions Addressing concerns of low wages and lack of financial incentives may have the potential to attract and retain employees to help alleviate nursing home staff shortages. Additionally, access to mental health resources could help nursing home staff cope with the emotional burden of the COVID-19 pandemic. These frontline staff members provided invaluable insight and should be included in improvement efforts to support nursing homes recovering from the impact of COVID-19 as well as future pandemic planning.


Author(s):  
Sruthi Valluri ◽  
Susan M. Mason ◽  
Hikaru Hanawa Peterson ◽  
Simone A. French ◽  
Lisa J. Harnack

Abstract Background The Supplemental Nutrition Assistance Program (SNAP) is the largest anti-hunger program in the United States. Two proposed interventions to encourage healthier food expenditures among SNAP participants have generated significant debate: financial incentives for fruits and vegetables, and restrictions on foods high in added sugar. To date, however, no study has assessed the impact of these interventions on the benefit cycle, a pattern of rapid depletion of SNAP benefits that has been linked to worsening nutrition and health outcomes over the benefit month. Methods Low-income households not currently enrolled in SNAP (n = 249) received benefits every 4 weeks for 12 weeks on a study-specific benefit card. Households were randomized to one of four study arms: 1) incentive (30% incentive for fruits and vegetables purchased with study benefits), 2) restriction (not allowed to buy sugar-sweetened beverages, sweet baked goods, or candy using study benefits), 3) incentive plus restriction, or 4) control (no incentive or restriction). Weekly household food expenditures were evaluated using generalized estimating equations. Results Compared to the control group, financial incentives increased fruit and vegetable purchases, but only in the first 2 weeks after benefit disbursement. Restrictions decreased expenditures on foods high in added sugar throughout the benefit month, but the magnitude of the impact decreased as the month progressed. Notably, restrictions mitigated cyclical expenditures. Conclusions Policies to improve nutrition outcomes among SNAP participants should consider including targeted interventions in the second half of the month to address the benefit cycle and attendant nutrition outcomes. Trial registration ClinicalTrial.gov, NCT02643576. Retrospectively registered December 22, 2014.


Forests ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 15 ◽  
Author(s):  
Ibtisam Al Abri ◽  
Kelly Grogan

The dramatic increase in the number of uncontrollable wildfires in the United States has become an important policy issue as they threaten valuable forests and human property. The derived stochastic dynamic model of this study is capable of determining optimal fuel treatment timing and level simultaneously and as a function of fire risk and fuel biomass dynamics. This study develops a stochastic dynamic model to evaluate the interaction of fuel treatment decisions for two adjacent landowners under various scenarios of misinformation about fire occurrence and spread. Findings indicate that a landowner tends to free ride on fuel treatment undertaken by his adjacent landowner. However, the study finds that the free riding potential of a landowner could be alleviated to some extent by having a neighboring landowner who is aware of fire spillover effects. In addition, the study reveals that the social cost resultant from free riding behavior is lower that the social cost associated with complete absence of fire externality awareness for both landowners. These findings imply that governments could introduce more effective educational programs to ensure that all landowners are fully aware of cross-parcel benefits of fuel treatment in order to align socially and privately optimal decisions, thus minimizing externality costs.


2021 ◽  
Vol 17 (6) ◽  
pp. 489-497
Author(s):  
Martha O. Kenney, MD ◽  
Benjamin Becerra, DrPH; MBA, MPH, MS ◽  
Sean Alexander Beatty, BA ◽  
Wally R. Smith, MD

Objective: The coronavirus disease 2019 (COVID-19) has led to a rapid transition to telehealth services. It is unclear how subspecialists managing painful chronic diseases—such as sickle cell disease (SCD), an inherited hemoglobinopathy with significant disparities in access and outcomes—have viewed the transition to telehealth or altered their pain management practices. This study elicits the views of sickle cell providers regarding their transition to telehealth and their opioid prescribing patterns during the COVID-19 pandemic.Design: An anonymous online survey was sent to eligible sickle cell providers.Setting: Comprehensive sickle cell centers and/or clinics across the United States. Participants: Physicians and advanced practice providers providing care to SCD patients.Main outcome measures: Respondents answered questions regarding their (1) views of telehealth compared to in-person encounters and (2) opioid prescribing practices during the early months of the pandemic.Results: Of the 130 eligible participants, 53 respondents from 35 different sickle cell centers completed at least 90 percent of the survey. Respondents reported a significant increase in telehealth encounters for routine and acute appointments (mean difference and standard deviation: 57.6 ± 31.9 percent, p 0.001 and 24.4 ± 34.1 percent, p 0.001, respectively) since COVID-19. The overwhelming majority of respondents reported no changes in their opioid prescribing patterns since COVID-19, despite increased telehealth use. Only a minority coprescribed naloxone as a risk mitigation strategy.Conclusion: The rapid uptake of telehealth has not suppressed ambulatory providers’ prescribing of opioids for SCD. Studies assessing the impact of the COVID-19 pandemic and telehealth on opioid prescribing practices in other painful chronic diseases are needed to ensure health equity for vulnerable pain patients.


Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 380 ◽  
Author(s):  
Jose A. Betancourt ◽  
Matthew A. Rosenberg ◽  
Ashley Zevallos ◽  
Jon R. Brown ◽  
Michael Mileski

The impact of COVID-19 on the U.S. healthcare industry cannot be overstated. Telemedicine utilization increased overnight as all healthcare providers rushed to implement this delivery model to ensure accessibility and continuity of patient care. Our research objective was to determine measures that were implemented to accommodate community and individual patient needs to afford access to critical services and to maintain safety standards. We analyzed literature since 2016 from two databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We compared observations, themes, service lines addressed, issues identified, and interventions requiring in-person care. From 44 articles published, we identified ten effectiveness themes overall and drew conclusions on service line successes. COVID-19 has caused rapid expansion in telemedicine. Necessary and required changes in access, risk mitigation, the need for social distancing, compliance, cost, and patient satisfaction are a few of the driving factors. This review showcased the healthcare industry’s ability to rapidly acclimate and change despite the pervasive spread of COVID-19 throughout the U.S. Although imperfect, unique responses were developed within telemedicine platforms to mitigate disruptions broadly and effectively in care and treatment modalities.


2019 ◽  
Vol 45 (4) ◽  
pp. 349-369 ◽  
Author(s):  
Jacqueline LaManna ◽  
Michelle L. Litchman ◽  
Jane K. Dickinson ◽  
Andrew Todd ◽  
Mary M. Julius ◽  
...  

Purpose The primary purpose of this study is to report a systematic review of evidence and gaps in the literature among well-conducted studies assessing the impact of diabetes education on hypoglycemia outcomes and secondarily reporting the impact on other included target outcomes. Methods The authors used a modified Cochrane method to systematically search and review English-language titles, abstracts, and full-text articles published in the United States between January 2001 and December 2017, with diabetes education specified as an intervention and a directly measurable outcome for hypoglycemia risk or events included. Results Fourteen quasi-experimental, experimental, and case-control studies met the inclusion criteria, with 8 articles reporting a positive impact of diabetes self-management education and support (DSMES) on hypoglycemia outcomes; 2 of the 8 reported decreased hypoglycemia events, and 1 reported decreased events in both the intervention and control groups. In addition, 5 studies targeted change in reported hypoglycemia symptoms, with all 5 reporting a significant decrease. DSMES also demonstrated an impact on intermediate (knowledge gain, behavior change) and long-term (humanistic and economic/utilization) outcomes. An absence of common hypoglycemia measures and terminology and suboptimal descriptions of DSMES programs for content, delivery, duration, practitioner types, and participants were identified as gaps in the literature. Conclusions Most retained studies reported that diabetes education positively affected varied measures of hypoglycemia outcomes (number of events, reported symptoms) as well as other targeted outcomes. Diabetes education is an important intervention for reducing hypoglycemia events and/or symptoms and should be included as a component of future hypoglycemia risk mitigation studies.


SAGE Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 215824402097967
Author(s):  
Faisal Abbas ◽  
Omar Masood ◽  
Shoaib Ali ◽  
Sohail Rizwan

This study aims to examine the impact of different capital ratios on Non-Performing loans, Loan Loss Reserves, and Risk-Weighted Assets by studying large commercial banks of the United States. The study employed a two-step system generalized method of movement (GMM) approach by collecting the data over the period ranging from 2002 to 2018. The study finds that using Non-Performing loans and Loan Loss Reserves as a proxy for risk, results support moral hazard hypothesis theory, whereas the results support regulatory hypothesis theory when Risk-Weighted Assets is used as a proxy for risk. The results confirm that the influence of high-quality capital on Non-Performing loans, Loan Loss Reserves, and Risk-Weighted Assets is substantial. The distinctive signs of Non-Performing loans, Loan Loss Reserves, and Risk-Weighted Assets have indications for policymakers. The results are intimate for formulating new guidelines regarding risk mitigation to recognize Non-Performing loans and Loan Loss Reserves and the Risk-Weighted Assets for better results. JEL Classification: G21, G28, G29


Author(s):  
David E. Olson

Despite all the attention paid to the growing prison populations in the United States since the early 1990s, it remains, as it has throughout recent history, that probation accounts for the largest portion of those under the custody of the criminal justice system. The U.S. Department of Justice estimates that at the end of 2015, there were more than 3.7 million adults under the supervision of U.S. probation authorities, compared to 1.5 million in prison, 870,000 on parole, and 728,000 in local jails. And while probation is not often thought about within the context of “mass incarceration” in the United States, probation directly impacts prison and jail populations in two specific ways. First, a sentence of probation for a felony offense is the most frequent alternative to a prison sentence. Second, the revocation of probation can directly lead to the imposition of a sentence to prison or jail, depending on the nature of the original conviction offense. During 2015, in the United States, it is estimated that 12% of all probationers exiting supervision were incarcerated due to probation revocation, which translates to an estimate of more than 233,000 probationers annually. Probation revocation means that the sentencing court has determined that a violation of the conditions of probation have occurred, and because of this, the original probation sentence is no longer appropriate. As a result of a probation sentence being revoked, the sentencing court imposes a different (usually more serious) sanction on the offender. Often, those on probation for a felony offense who have their probation revoked are sentenced to prison, leading to their admission to prison. Indeed, given this link, scholars and practitioners have identified reducing probation revocation as one strategy to reducing prison populations, and jurisdictions often focus on reducing probation revocations as a means to lowering their commitments to prison. Probation revocation can result from either new arrests or violations of technical aspects of the sentence, such as missed appointments or non-compliance with treatment orders. However, whether or not a probation sentence is revoked as a result of these violations varies from jurisdiction to jurisdiction. This variation in the use of probation revocation as a response to violations of probation illustrates the localized nature of revocation proceedings, and attempts to reduce these disparities have taken many forms. These efforts to reduce the impact of probation revocations on prison admissions have ranged from providing local jurisdictions with financial incentives to respond to revocation-eligible violations with sanctions other than incarceration, to legislative efforts to prohibit sentences to prison as a response to probation revocations stemming from technical violations or instances where public safety is not threatened.


2021 ◽  
Vol 19 (9) ◽  
pp. 81-90
Author(s):  
Kelsey L. Merlo, PhD ◽  
Katrina M. Conen, BA ◽  
Blake Scott, MPH ◽  
Kayla Jones, MA ◽  
Elizabeth A. Dunn, MPH, CPH ◽  
...  

The coronavirus-2019 (COVID-19) pandemic cor­responded with a record-breaking year for billion-dollar disasters. While the pandemic swept across the United States, the country also experienced a record-setting hurricane season on the East Coast and an unprecedented wildfire season on the West Coast. These co-occurring threats have placed unprecedented strain on our disaster response workforce with poten­tial long-term implications for turnover and disaster response efficacy. In this paper, we draw from the Job Demands-Resources model to address the influence of workers’ role stressors and community infection rates during the COVID-19 pandemic and job burnout and turnover in the disaster response workforce. 


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1055-1056
Author(s):  
Amy Meehan ◽  
Renee Shield ◽  
Caroline Madrigal ◽  
Joan Brazier ◽  
Emily Gadbois

Abstract As COVID-19 has resulted in a skilled nursing facility (SNF) staffing crisis, administrators attempt to maintain adequate staffing and stem decreasing patient census levels. We conducted four repeated interviews to date (n=130) at 3-month intervals with administrators from 40 SNFs in eight diverse healthcare markets across the United States. We used thematic analysis to examine their perspectives over time, including the perceived impact on staffing. Results include: 1) the impact of COVID-19 on staffing levels, and 2) strategies used in response to this crisis. Staffing levels have decreased throughout the pandemic, and struggles to maintain adequate staffing levels and patient census numbers have continued as the pipeline of potential new staff constricts. Facilities turned to agencies, many for the first time. Since agencies offer higher salaries, staff are drawn away from employment by SNFs, leading to a cycle of wage wars, and agencies are also challenged to provide staff. SNF administrators describe their responses to this crisis, such as flexible schedules, increased paid time off, sharing of non-direct-patient-care tasks, financial incentives (referral, sign-on, “no-call out”, and other general bonuses); wage analyses, and enhanced employee benefit packages. Some hire recruitment specialists, collaborate with nearby administrators, use creative advertising, or work with local schools. The vaccine mandate worries administrators; as one stated: “I can't afford to lose one person, let alone 20 because of this mandate...”. Given the dwindling pool of potential employees, we present NH administrators’ strategies to attract and retain staff.


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