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This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

Brazil’s regional inequality is an important topic due to the large and persistent differences in development between states and the high levels of inequality in the country. These variations in development can potentially render survey data inaccurate since the significance of capital income varies across the states. Besides, previous studies incorporating tax and national accounts data globally have mainly focused on measuring the income distribution at the country-level. This approach can limit the understanding of inequality, especially when considering large countries such as Brazil.

The methodology used to construct these estimates follows the guidelines of the Distributional National Accounts, whose core goal is to provide income distribution measures consistent with macroeconomic aggregates and harmonized across countries and time. The procedure has three main steps: first, it corrects the survey’s underrepresentation of top incomes using tax data. Then, it accounts for national income items not included in the survey or tax data, such as imputed rents and undistributed profits. Finally, it ensures that all components match the national income.

Compared to survey-based estimations, the results reveal a new angle on the state-level inequality. This study indicates that Amazonas, Rio de Janeiro and São Paulo have a more concentrated income distribution. The top 1\% of earners in these states receives around 28\% of total pre-tax income, while the top 10\% receive nearly 60\%. On the other end, Amapá (AP), Acre (AC), Rondônia (RO) and Santa Catarina (SC) are the states where the income distribution is less concentrated. There were no significant changes in the income distribution across the states during the period analyzed.

This study combines survey, tax and national accounts data to construct new estimates of Brazil’s state-level income distribution from 2006 to 2019. Previous results only considered income captured in surveys, which usually misses a significant part of capital incomes. This limitation may bias comparisons as capital income has different importance across the states. The new estimates represent the income of top groups more accurately, account for the entire national income and enable to compare regional inequality levels consistently with other countries.

Using a large-scale school improvement program in Sweden as a case, this article aims to explore the state governance of a large-scale school improvement program in Sweden and how officials at the state agency level made sense of the reform ideas and operationalized them in policy actions.

Data were integrated from Swedish Government Official Reports and formal directives from the Ministry of Education. Officials of the Swedish National Agency for Education (SNAE) were also interviewed. Data were analyzed to identify how regulatory rules, professional norms and cultural–cognitive beliefs shaped SNAE's design of the program.

The article shows how different types of governance (i.e. regulatory rules, professional norms and cultural–cognitive beliefs) set the direction for managing large-scale school improvement. In particular, in the studied case, the lack of clear regulatory directives enabled sensemaking processes clearly influenced by normative ideas and cultural–cognitive beliefs.

The findings are mostly presented from the perspective of managers, so further study is required to attain a broader understanding of the state agency level's role and function.

By illustrating the strengths of understanding various dimensions of educational governance, the findings are highly relevant to both policymakers and educational managers at different levels of school systems.

The article offers a valuable perspective on large-scale school improvement and educational governance by focusing on a level that has hitherto received little attention.

In 2017, the opioid epidemic was declared a public health emergency in the United States. The federal and state governments are still struggling to contain the crisis through various legislations and to stem the tide of overdoses and deaths. This paper looks specifically at the issue of high prescriptions of opioids disbursed to patients by physicians.

This paper evaluates this evolving policy issue through a critical review and synthesis of academic literature, government policy documents (at states and national levels) and articles in the popular press.

Over-prescription is a legal problem because it inevitably leads to diversion of these substances for non-medical usage. The Prescription Drug Monitoring Program (PDMP) laws have been passed by all 50 states and the main policy responses are covered. However, there are hindrances to their effectiveness, which have to be addressed. Two state level policy alternatives are discussed as potential solutions — PDMP mandates and Pain Management Clinic Laws (PMCLs). After a comparative evaluation, it is recommended that all states should pass the mandatory PDMP review and usage laws urgently.

This is the first detailed policy evaluation on the specific and time-sensitive aspect of physician over-prescribing, within the larger opioid abuse problem. Moreover, critique on the public health leadership issue is raised.

The purpose of this study is to provide new insights into the relationship between fiscal policy and total factor productivity (TFP) while accounting for several economic and econometric issues of the phenomenon like non-stationarity, fiscal feedback effects, persistence in productivity, country heterogeneity and unobserved global shocks and local spillovers affecting heterogeneously the countries in the sample.

The paper is empirical. It builds an Error Correction Model (ECM) specification within a dynamic heterogeneous framework with common correlated effects and models both reverse causality and feedback effects.

The results of this study highlight some new findings relative to the existing related literature. The outcomes suggest some relevant evidence at both the academic and policy levels: (1) the causal effects going from fiscal deficit/surplus to TFP are heterogeneous across countries; (2) the effects depend on the time horizon considered; (3) the long-run dynamics of TFP are positively impacted by improvements in fiscal budget, but only if the austerity measures do not exert slowdowns in aggregate growth.

The main originality of this study is methodological, with possible extensions to related phenomena. Relative to the existing literature, the gains of this study rely on the way econometric techniques, recently proposed in the literature, are adapted to the economic relationship of interest. The endogeneity due to the existence of reverse causality is modelled without implying relevant performance losses of the models. Moreover, this is the first article that questions whether the effects of fiscal budget on productivity depend on the impact of the former on aggregate output growth, thus emphasising the importance of the quality of fiscal adjustments.

This study aims to explore how sustainable business models (SBM) can be developed within agri-innovation systems (AIS) and emphasize an integration of the two with a systemic understanding for reducing food loss and value loss in postharvest agri-food supply chain.

This study conducted longitudinal qualitative research in a developing country with food loss challenges in the postharvest supply chain. This study collected data through multiple rounds of fieldwork, interviews and focus groups over four years. Thematic analysis and “sensemaking” were used for inductive data analysis to generate rich contextual knowledge by drawing upon the lived realities of the agri-food supply chain actors.

First, this study finds that the value losses are varied in the supply chain, encompassing production value, intrinsic value, extrinsic value, market value, institutional value and future food value. This happens through two cumulative effects including multiplier losses, where losses in one model cascade into others, amplifying their impact and stacking losses, where the absence of data stacks or infrastructure pools hampers the realisation of food value. Thereafter, this study proposes four strategies for moving from the loss-incurring current business model to a networked SBM for mitigating losses. This emphasises the need to redefine ownership as stewardship, enable formal and informal beneficiary identification, strengthen value addition and build capacities for empowering communities to benefit from networked SBM with AIS initiatives. Finally, this study puts forth ten propositions for future research in aligning AIS with networked SBM.

This study contributes to understanding the interplay between AIS and SBM; emphasising the integration of the two to effectively address food loss challenges in the early stages of agri-food supply chains. The identified strategies and research propositions provide implications for researchers and practitioners seeking to accelerate sustainable practices for reducing food loss and waste in agri-food supply chains.

The purpose of this paper is to evaluate the influence of budgeting process elements (budget participation, preparation, implementation and evaluation) on budget performance of government.

A cross-sectional survey was administered among budget officers from government agencies, departments, and units in Malaysia. Descriptive and regression analyses were used to examine the relationship between the budgeting process and budget performance.

The findings revealed the significant influence of the two predictors: (1) budget participation and (2) budget implementation and evaluation, on budget performance. Both have positive and significant impacts on budget performance. However, budget preparation appeared to have no significant relationship with budget performance, although there is positive effect.

This study provides empirical evidence on the budgeting process factors that influence budget performance. The findings hopefully are of interest to government officials, especially frontline bureaucrats, who seek to ensure that budget performance meets expectations in Malaysia and other countries.

This article provides evidence of a long-term structural relationship between demand for heated tobacco products (HTPs) and for combustible cigarettes in a Marshallian demand framework, using data from the Italian market.

A cointegration-based approach allows to capture the substitution effects between the two products arising for reasons (possibly) other than price.

The authors find that such a relationship exists and is sufficiently strong to constitute a cointegration.

Since a fully consolidated consensus on reduced harm from smokeless tobacco products is absent, symmetric policies on both markets are therefore necessary in terms of regulation and excise incidence to minimize the social cost of substitution and to maximize government revenues, which are a necessary counterpart to negative externalities that arise with smoking both products.

This paper focuses on the Italian market with product specific volume and price data, both for cigarettes and HTPs. Because of the detected relationship, a regulatory trade-off arises in case of a relatively mild regulation on heated-tobacco products: benefits from decreasing demand for combustible cigarettes may be offset by the social cost of increasing consumption of heated tobacco products. Moreover, a milder regulation makes price related policies to curb smoking less effective.

The research management and administrator (RMA) profession in the Western Balkans (WB) has not yet been investigated. In this chapter, we provide a first insight into the current state of the profession, its evolution and existing network of peers within the region and between the region and Europe at large. We focus on the RMAs’ opinions about the policy level, on the institutional background and on networking initiatives that allow for the understanding of further development of the profession. Based on the findings of a focus group and a survey with the region’s RMAs, we provide insight into the challenges and opportunities as perceived by the RMAs themselves.