Policy integration, problem-solving, and the coronavirus disease crisis: lessons for policy design

The coronavirus disease pandemic has exposed differences in the capacity of governments around the world to integrate and coordinate different policy instruments into a coherent response. In this article, we conceptualize and empirically examine policy integration in responses to the coronavirus disease crisis in 35 countries. We then discuss how the interplay between restrictions, health protection, and economic policy has been articulated between, on the one hand, a policy design based on the complementarity of pro-public health and pro-economy measures, implying an integrated response, and, on the other, a policy design based on the perception of an inherent trade-off between the two. Finally, we discuss three implications from our analysis of policy integration against the coronavirus disease crisis for the post-COVID state: (a) the normalization and adaptation of integrated crisis responses; (b) the possible acceleration and “catching up” of problem-solving capacity as governments may use the crisis as an instance to put into place new social policies; and (c) policy integration as an accelerator of policy complexity and resistance against technocracy in the post-COVID state.

Multilevel Determinants of Integrated Service Delivery for Intimate Partner Violence and Mental Health in Humanitarian Settings

Inter-agency guidelines recommend that survivors of intimate partner violence in humanitarian settings receive multisectoral services consistent with a survivor-centered approach. Providing integrated services across sectors is challenging, and aspirations often fall short in practice. In this study, we explore factors that influence the implementation of a multisectoral, integrated intervention intended to reduce psychological distress and intimate partner violence in Nyarugusu Refugee Camp, Tanzania. We analyzed data from a desk review of donor, legal, and policy documents; a gender-based violence services mapping conducted through 15 interviews and 6 focus group discussions; and a qualitative process evaluation with 29 stakeholders involved in the implementation of the integrated psychosocial program. We identified the challenges of implementing a multisectoral, integrated intervention for refugee survivors of intimate partner violence at the structural, inter-institutional, intra-institutional, and in social and interpersonal levels. Key determinants of successful implementation included the legal context, financing, inter-agency coordination, engagement and ownership, and the ability to manage competing priorities. Implementing a multisectoral, integrated response for survivors of intimate partner violence is complex and influenced by interrelated factors from policy and financing to institutional and stakeholder engagement. Further investment in identifying strategies to overcome the existing challenges of implementing multisectoral approaches that align with global guidelines is needed to effectively address the burden of intimate partner violence in humanitarian settings.

Effects of Algorithmic Music on the Cardiovascular Neural Control

Music influences many physiological parameters, including some cardiovascular (CV) control indices. The complexity and heterogeneity of musical stimuli, the integrated response within the brain and the limited availability of quantitative methods for non-invasive assessment of the autonomic function are the main reasons for the scarcity of studies about the impact of music on CV control. This study aims to investigate the effects of listening to algorithmic music on the CV regulation of healthy subjects by means of the spectral analysis of heart period, approximated as the time distance between two consecutive R-wave peaks (RR), and systolic arterial pressure (SAP) variability. We studied 10 healthy volunteers (age 39 ± 6 years, 5 females) both while supine (REST) and during passive orthostatism (TILT). Activating and relaxing algorithmic music tracks were used to produce possible contrasting effects. At baseline, the group featured normal indices of CV sympathovagal modulation both at REST and during TILT. Compared to baseline, at REST, listening to both musical stimuli did not affect time and frequency domain markers of both SAP and RR, except for a significant increase in mean RR. A physiological TILT response was maintained while listening to both musical tracks in terms of time and frequency domain markers, compared to baseline, an increase in mean RR was again observed. In healthy subjects featuring a normal CV neural profile at baseline, algorithmic music reduced the heart rate, a potentially favorable effect. The innovative music approach of this study encourages further research, as in the presence of several diseases, such as ischemic heart disease, hypertension, and heart failure, a standardized musical stimulation could play a therapeutic role.

Integrality in the Design of Urban Development Plans. Analysis of the Initiatives Promoted by the EU in Spain

Policy integration is a substantive and innovative strategy, used to address complex problems that go beyond the scope of sectoral policies, and require a joint and integrated response. While theoretical advances have been made in the field, there have not been many empirical proposals of a comparative nature. This paper develops a proposal for the analysis of integrality in the domain of urban policies, in which the integrated strategy has become a key component. Following a literature review, three dimensions were defined, referring to the diagnosis, the action strategy, and the project governance, which have allowed us to examine the presence of an integrated strategy in the designs of the projects developed within the framework of the URBAN and URBANA, initiatives implemented in Spain between 1994 and 2013, promoted by the European Union (EU). The results show that, as occurs in other public policies, the extent of the integrated strategy is limited and varies according to the dimensions. Moreover, the differences found between the two initiatives support the idea that policy integration is a gradual and dynamic process, with a certain learning effect, which develops over time and in which the dimensions of integration do not evolve in a coordinated manner.