Designing Public Health Policy to Curb Health and Economic Impact of Khat Chewing

Introduction and Background: Khat (Catha edulis Forsk) known for long period as an indigenous plant to Ethiopia, has many mixed effects and impact. Some consider it as a good means to socialize. Others consider it as a good source of income. Nowadays, as a result of its effect on health, public health concern is growing. However, there are no policies controlling these khat effects. Objective: To present policy option to curtail health and economic impact of khat chewing practice in Ethiopia. Methods: Narrative literature review was made to look into different effects of khat chewing with a particular reference to Ethiopia. Key findings khat chewing has stimulating, euphoric and addictive effects. It has a constricting effect on blood vessels leading to hypertension. It has also neuropsychiatric and physical consequences including aggression, suicidal ideation, anxiety, paranoia, manic behaviors, insomnia, depression, increased heart rate, anorexia and weight loss, dental and pulmonary problems. Additionally, khat abuse found linked to liver damage and failure. Conclusion: Given that medical risks of khat use are modest, or studies are not conclusive, there should be a regulatory framework with the objective of protecting consumers and community. This is best achieved by establishing processes for the quality control of khat and by regulating access and availability. Conclusive studies are very rare and even some are inadequate and contradictory. Most of the evidences on adverse effects of khat come from case reports and observational studies. Therefore, high quality research is justified.

Biogas Generation from Bovine Confinement: An Energy Policy Option for Brazil

Brazil has the largest commercial beef herd in the world and is one of the most important players in the global agricultural market, notably for soybeans. Agriculture has an important demand for energy and emits significant quantities of greenhouse gases (GHG). To minimize the effects generated by livestock activities, from both the energetic and environmental perspectives, there exists the possibility of the use of biogas generated from beef cattle confinement. This productive system allows the reduction of methane emissions from enteric fermentation and from manure through the production of biogas. This has become an option for energy policy by contributing to the offer of energy and the reduction of the demand of agriculture for fossil fuels. With a renewable energy resource, the agricultural sector dependent on non-renewable resources, also reduces its dependence on exhaustible resources, so that a policy aimed at the use of biogas and partial energetic autonomy becomes strategic for the sector. The article analyses biogas production potential from waste throughout the entire beef production chain in more intensive systems (total or partial confinement of beef cattle). These solutions can contribute both to the offer of electric energy to the agricultural sector in the country, increasing its productivity, and to the reduction of greenhouse gases.

Promoting Landscape-Level Forest Management in Fire-Prone Areas: Delegate Management to a Multi-Owner Collaborative, Rent the Land, or Just Sell It?

Forest management at the landscape level is a requirement for reducing wildfire hazard. In contexts where non-industrial private forest ownership prevails, the collaboration among multiple owners has been proposed as the way forward to reach consistent fuel management at that level. The current literature has been focused on identifying the factors that lead to collaboration among owners. In this study we explored other ways to reach landscape-level management in addition to the collaborative way, such as those that may be promoted through land renting or selling. Different contexts and owner types may require different solutions. Thus, we explicitly asked which alternative would be chosen by a given forest owner, from the following set: keeping individual management, entering a multi-owner collaborative arrangement where they delegate management, renting to a pulp company; or selling the land. In a context of small-scale ownership and high recurrence of wildfires in Portugal, a face-to-face survey was carried out to a sample of landowners. Our results suggest that there is not an a priori generalized unwillingness of owners to delegate management, rent or sell the land and thus they seem prone to align themselves with policy strategies to promote management at the landscape level. Multinomial logit regression modelling allowed us to explain and predict owners’ choices among the aforementioned set of alternative management options. We found that choosing multi-ownership collaboration, as opposed to keeping current individual management, is associated with passive management under harsher conditions, by non-residents without bonding capital. The identified factors of owners’ choices show the limited scope of tenancy and land-market mechanisms to promote landscape-level management. The best policy option was found to depend on the owner profiles prevailing in the target area. This suggests that studying the existing context and owner types is required to design effective policies.

Green Light for Adaptive Policies on the Colorado River

The Colorado River is a critical source of water supply for 40 million people in nine states spanning two nations in western North America. Overallocated in the 20th century, its problems have been compounded by climate change in the 21st century. We review the basin’s hydrologic and water management history in order to identify opportunities for adaptive governance to respond to the challenge of reduced system flows and distill the ingredients of past successes. While significant advances have been made in the first two decades of the 21st century, these past actions have not been sufficient to halt the declines in the basin’s reservoirs. We find that the mix of federal, state, and local responsibility creates challenges for adaptation but that progress can be made through a combination of detailed policy option development followed by quick action at hydrologically driven moments of opportunity. The role of directives and deadlines from federal authorities in facilitating difficult compromises is noted. The current state of dramatically decreased overall flows has opened a window of opportunity for the adoption of water management actions that move the river system toward sustainability. Specific measures, based on the existing institutional framework and on policy proposals that have circulated within the Colorado River community, are suggested.

Public-private partnerships in the provision of homeopathic services in the city of Delhi, India

Homeopathy is one among the popular medical systems in India. Over the years, the government has been attempting to mainstream homeopathy in the public health system, nevertheless, most service providers are in the private sector. Therefore, increase of quality and availability to all population classes by means of public-private partnerships is seen as a viable policy option. In Delhi, 90% of homeopathic services providers belong to the private sector, including charity trusts. Most of them provide services to the low-income population in urban slams. In 2003, Delhi government launched a program involving the private sector to provide homeopathic services in underserved city areas. This project funded private agencies to run homeopathic clinics. This paper provides an overview on this program, addressing in particular the lessons taught by six case studies represented by non-governmental organizations (NGOs). It also discusses expectations of private providers and concludes with specific recommendations for wider participation of the private sector.

How can solar geoengineering and mitigation be combined under climate targets?

So far, scientific analyses have mainly focused on the pros and cons of solar geoengineering or solar radiation management (SRM) as a climate policy option in mere isolation. Here, we put SRM into the context of mitigation by a strictly temperature-target-based approach. As the main innovation, we present a scheme that extends the applicability regime of temperature targets from mitigation-only to SRM-mitigation analyses. We explicitly account for one major category of side effects of SRM while minimizing economic costs for complying with the 2 ∘C temperature target. To do so, we suggest regional precipitation guardrails that are compatible with the 2 ∘C target. Our analysis shows that the value system enshrined in the 2 ∘C target leads to an elimination of most of the SRM from the policy scenario if a transgression of environmental targets is confined to 1/10 of the standard deviation of natural variability. Correspondingly, about half to nearly two-thirds of mitigation costs could be saved, depending on the relaxation of the precipitation criterion. In addition, assuming a climate sensitivity of 3 ∘C or more, in case of a delayed enough policy, a modest admixture of SRM to the policy portfolio might provide debatable trade-offs compared to a mitigation-only future. Also, in our analysis which abstains from a utilization of negative emissions technologies, for climate sensitivities higher than 4 ∘C, SRM will be an unavoidable policy tool to comply with the temperature targets. The economic numbers we present must be interpreted as upper bounds in the sense that cost-lowering effects by including negative emissions technologies are absent. However, with an additional climate policy option such as carbon dioxide removal present, the role of SRM would be even more limited. Hence, our results, pointing to a limited role of SRM in a situation of immediate implementation of a climate policy, are robust in that regard. This limitation would be enhanced if further side effects of SRM are taken into account in a target-based integrated assessment of SRM.

A framework to guide policymakers on the use of science to inform public health policy and law: Immunisation as a case study

<p>This thesis examines the incorporation of science into public health policy/law. The key problem that the thesis tackles is the blurring of science and values arguments in the creation of policy/law. To overcome this problem, a decision-making framework is proposed that draws a distinction between arguments based on science and those based on values. The framework suggests categorising science as information obtained by adherence to the scientific method. Values, then, are those legally protected rights, freedoms and principles that do not follow scientific methodology. Examples include public health as a community value, informed consent, freedom of choice, and religious beliefs. The idea is that the acquisition of scientific knowledge through the scientific process provides the platform from which debate about values can begin. It is acknowledged that scientific methodology does not entail an absence of values, and the reality may be the separation is more of a continuum than two distinct groups. The shorthand labels (values and science) are used for functional purposes to describe the stages of the proposed framework. There are three stages to the framework. The first stage acts as a gatekeeper, preventing non-scientific components being confused with science. The second stage addresses values, particularly rights and freedoms protected by law. The third stage looks at whether a health policy option (which could involve new law) that restricts existing rights protected by law can nevertheless be justified. Examples relating to the immunisation of children are used to help describe how the framework could work when applied to a real-world public health policy issue.</p>

A framework to guide policymakers on the use of science to inform public health policy and law: Immunisation as a case study

<p>This thesis examines the incorporation of science into public health policy/law. The key problem that the thesis tackles is the blurring of science and values arguments in the creation of policy/law. To overcome this problem, a decision-making framework is proposed that draws a distinction between arguments based on science and those based on values. The framework suggests categorising science as information obtained by adherence to the scientific method. Values, then, are those legally protected rights, freedoms and principles that do not follow scientific methodology. Examples include public health as a community value, informed consent, freedom of choice, and religious beliefs. The idea is that the acquisition of scientific knowledge through the scientific process provides the platform from which debate about values can begin. It is acknowledged that scientific methodology does not entail an absence of values, and the reality may be the separation is more of a continuum than two distinct groups. The shorthand labels (values and science) are used for functional purposes to describe the stages of the proposed framework. There are three stages to the framework. The first stage acts as a gatekeeper, preventing non-scientific components being confused with science. The second stage addresses values, particularly rights and freedoms protected by law. The third stage looks at whether a health policy option (which could involve new law) that restricts existing rights protected by law can nevertheless be justified. Examples relating to the immunisation of children are used to help describe how the framework could work when applied to a real-world public health policy issue.</p>

Looking for a North Star? Ideological justifications and trade unions’ preferences for a universal basic income

Trade unions are often said to be hostile to a universal basic income (UBI). Their judgement may be affected by factors such as their work ethic, perceptions of the unemployed and preferences for labour decommodification. Yet, most studies fail to sketch out the reasons for which unions oppose or support a UBI from a normative standpoint. To understand the impact of ideology on unions’ appreciation for a UBI, I integrate results from 62 questionnaires with 27 in-depth qualitative interviews. This study illustrates that unions’ preferences for a UBI are associated with their theoretical understanding of labour, diverging substantially across welfare regimes. Whereas unions from Bismarckian and Nordic countries are generally opposed to a UBI, organizations from Liberal and Mediterranean countries tend to see UBI as a legitimate policy option. However, in some circumstances they set aside the policy for pragmatic reasons, thus disconnecting their normative orientations from perceptions of its concrete viability.