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<b><i>Aims:</i></b> This paper describes the development and pilot-testing of The Family Health History Training Program for Health Educators (FHHTP). Although in recent years professional organizations have urged the health promotion workforce to adopt genomics-related competencies, training opportunities designed specifically for health educators (HEs) remain scarce. Designed by a team of HEs, the FHHTP aims at preparing HEs in the state of Texas, USA, to use a family health history as a genomic health promotion tool. <b><i>Methods:</i></b> In this report, we describe (a) the program's empirical and theoretical grounding, (b) its components, and (c) pilot-testing of the 2 main components (Web-based and workshop trainings). The FHHTP addresses the training needs expressed by HEs and anchors itself in a theoretical model previously tested with 1,607 US-based HEs. The model draws from Social Cognitive Theory, the Theory of Planned Behavior, and Diffusion of Innovations theory. The program comprises 6 elements; the Web-based training and the training workshops are the focus of this paper. <b><i>Results:</i></b> Pilot data indicate participants' knowledge and intention improved significantly (p < 0.05) at post-test and remained significantly higher at the 3-month follow-up. Attitudes, self-efficacy, behavior, knowledge/awareness, and intention also exhibited improvement in scores over time. <b><i>Conclusion:</i></b> We conclude, therefore, that the FHHTP can contribute significantly to the adoption of genomic competencies by Texas HEs. This report describes how the first-of-its-kind genomics training for HEs in the USA - FHHTP - was developed and pilot-tested with HEs in Texas.

Background: In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme ( GIS) and Labour Insurance Scheme ( LIS) to the new Urban Employee Basic Health Insurance Scheme ( BHIS). Methods: This paper uses data from the National Health Services Surveys of 1998 and 2003 to examine the impact of the reform on population coverage. Particular attention is paid to coverage in terms of gender, age, employment status, and income levels. Following a description of the data between the two years, the paper will discuss the relationship between the insurance reform and the growing inequities in population coverage. Results: An examination of the data reveals a number of key points: a) The overall coverage of the newly established scheme has decreased from 1998 to 2003. b) The proportion of the urban population without any type of health insurance arrangement remained almost the same between 1998 and 2003 in spite of the aim of the 1997 reform to increase the population coverage. c) Higher levels of participation in mainstream insurance schemes ( i. e. GIS-LIS and BHIS) were identified among older age groups, males and high income groups. In some cases, the inequities in the system are increasing. d) There has been an increase in coverage of the urban population by non-mainstream health insurance schemes, including non-commercial and commercial ones. The paper discusses three important issues in relation to urban insurance coverage: institutional diversity in the forms of insurance, labour force policy and the non-mainstream forms of commercial and non-commercial forms of insurance. Conclusion: The paper concludes that the huge economic development and expansion has not resulted in a reduced disparity in health insurance coverage, and that limited cross-group ...

In the late 1980s, Chile planned to privatize Santiago's sanitary works enterprise (EMOS) but instead reformed it under public ownership. It did so through a regulatory framework that mimicked the design of a concession with a private utility, setting tariffs that ensured at least a seven percent return on assets, creating a neutral regulator independent of ministry intervention, and giving EMOS the right to appeal the regulator's tariff decisions. This reform of Santiago's water system is often cited as a case of successful reform under public management. Comparing a comprehensive measure of welfare with a counterfactual example, the authors show surprisingly large gains from Santiago's reform, given the relatively good initial conditions. (The gains accrued largely to government and employees, but consumers benefited from improved service and coverage). Why did reform in Santiago improve water system performance, when similar reform attempts under public management in other countries failed? 1) Chile has a long tradition of private water rights, shaped by early recognition that water is a scarce and tradable private good. 2) The reformed regulatory framework was designed to attract private investors to the water system and to motivate them to operate efficiently and expand the system. 3) Chile's unique electoral institutions sustained this framework under state operation after democracy was restored. 4) Chile's strong bureaucratic norms and institutions (permitting little corruption), combined with Santiago's relatively low-cost water system, permitted prices that effectively increased quasi-rents for investing in the system while minimizing the risk of inefficiency or monopoly rents. The authors also address the question of why EMOS was reformed but not privatized, and what the costs of not privatizing were. The system was privatized in 1999, but the changes from privatization are likely to be less significant than those introduced in 1989-90.

Are COVID-19 spread and mortality related to different countries' government mobility restriction policies, democratic institutions, and cultural norms? Leveraging data from 140 countries, we find that policy, institutions, and vulnerabilities interact to determine pandemic spread and mortality. A delay in restricting international mobility increases pandemic mortality. Combining vulnerabilities with a delay in domestic mobility restrictions increases mortality. Democratic countries have faster policy responses and lower pandemic mortality, but they also face more adverse effects from a delay in restricting domestic mobility. More individualistic countries have a higher pandemic spread, and their delay in domestic mobility restrictions is associated with higher pandemic mortality.

China has long been the world's leading plastic waste importer. However, in January 2018 the Chinese Government enacted a new policy to permanently ban the import of most plastic waste into the country. This raises an important question: what will the impact of this policy be both domestically and globally? It is argued that the answer to this question can in part be systematically revealed by employing three methods of analysis. (1) A combined multiregional input-output model with structural path analysis (SPA) to understand how consumption patterns domestically and globally drive China's plastic waste imports. (2) An ecological network analysis to identify which region is the dominant controller of the global plastic waste trade network. Lastly, (3) a hypothetical extraction method to investigate the value-added change for China and the increased requirement of waste treatment capacity for other economies. The results indicate that the imported plastic waste was mainly driven by China's domestic consumption of products containing recycled plastic. Given this demand, it is recommended that the Chinese Government undertake various actions to increase local plastic waste recycling to compensate for the loss of recycled plastic material since the import ban took place. China is a dominant controller, along with the US, the European Union and Germany of the global plastic waste trade network. At this stage it is not possible for other large economies to replace the role of China in the short term. China's waste import ban caused a minor economic loss for China, however, it has resulted in the need for other economies to increase their waste treatment capacity. As well as increasing local plastic waste recycling, it is recommended the Chinese Government consider reopening imports for high quality recycled material and to seek global collaboration, which would not only ease the shortage of recycled plastic material but also buy time for other economies to build new waste treatment plants.

Hand grip strength is a widely used proxy of muscular fitness, a marker of frailty, and predictor of a range of morbidities and all-cause mortality. To investigate the genetic determinants of variation in grip strength, we perform a large-scale genetic discovery analysis in a combined sample of 195,180 individuals and identify 16 loci associated with grip strength (P<5 × 10−8) in combined analyses. A number of these loci contain genes implicated in structure and function of skeletal muscle fibres (ACTG1), neuronal maintenance and signal transduction (PEX14, TGFA, SYT1), or monogenic syndromes with involvement of psychomotor impairment (PEX14, LRPPRC and KANSL1). Mendelian randomization analyses are consistent with a causal effect of higher genetically predicted grip strength on lower fracture risk. In conclusion, our findings provide new biological insight into the mechanistic underpinnings of grip strength and the causal role of muscular strength in age-related morbidities and mortality. ; This research has been conducted using the UK Biobank Resource. The Fenland Study is supported by the UK Medical Research Council (MRC) (MC_UU_12015/1; MC_UU_12015/2; MC_UU_12015/3). EPIC-Norfolk is supported by the MRC (G401527, G1000143) and Cancer Research UK (A8257). The HCS is gratefully supported by the University of Newcastle (Australia) and the Fairfax Family Foundation. Sydney MAS is supported by the Australian National Health and Medical Research Council (NHMRC), grants ID568969, ID350833 and ID109308. Sydney MAS DNA was extracted by Genetic Repositories Australia, funded by NHMRC Enabling Grant 401184. The GEFOS Study, used as controls for the US and Jamaican athletes, was supported in part by NIH grants U01 HG004436 and P30 DK072488, and the Baltimore Geriatrics Research, Education, and Clinical Center of the Department of Veterans Affairs. The Novo Nordisk Foundation Center for Basic Metabolic Research is an independent Research Center at the University of Copenhagen partially funded by an unrestricted donation from the Novo Nordisk Foundation (www.metabol.ku.dk). TwinsUK was funded by the Wellcome Trust (WT), MRC, and European Union. The study also receives support from the National Institute for Health Research (NIHR) BioResource Clinical Research Facility and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. SNP Genotyping was performed by The WT Sanger Institute and National Eye Institute via NIH/CIDR. M.McC is a WT Senior Investigator and receives support from WT 090532 and 098381. TW is the recipient of a studentship from MedImmune. Research by A. Lucia is supported by Fondo de Investigaciones Sanitarias and Fondos Feder (grant # PI15/0558). EM-M. was a recipient of a Grant-in-Aid for JSPS Fellow from the Japan Society for the Promotion of Science. This work was supported in part by grants from the Grant-in-Aid for Scientific Research (B) (15H03081 to NF) of the Japanese Ministry of Education, Culture, Sports, Science and Technology and by a grant-in-aid for scientific research (to M. Miyachi) from the Japanese Ministry of Health, Labor, and Welfare. This work was further supported by NIH grants R01 AR41398 and U24 AG051129.

Using the data sets taken at center-of-mass energies above 4 GeV by the BESIII detector at the BEPCII storage ring, we search for the reaction e(+)e(-) -> gamma(ISR) X(3872) -> gamma(ISR)pi(+)pi(-) J/psi via the Initial State Radiation technique. The production of a resonance with quantum numbers J(PC) = 1(++) such as the X(3872) via single photon e(+)e(-) annihilation is forbidden, but is allowed by a next-to-leading order box diagram. We do not observe a significant signal of X(3872), and therefore give an upper limit for the electronic width times the branching fraction Gamma B-X(3872)(ee)(X(3872) -> pi(+)pi(-) J/psi) < 0.13 eVat the 90% confidence level. This measurement improves upon existing limits by a factor of 46. Using the same final state, we also measure the electronic width of the psi(3686) to be Gamma(psi)(ee)(3686) ee = 2213 +/- 18(stat) +/- 99(sys) eV. ; Funding: The BESIII collaboration thanks the staff of BEPCII and the IHEP computing center for their strong support. This work is supported in part by the National Key Basic Research Program of China under Contract No. 2015CB856700; National Natural Science Foundation of China (NSFC) under Contract Nos. 11125525, 11235011, 11322544, 11335008, 11425524; the Chinese Academy of Sciences (CAS) Large-Scale Scientific Facility Program; Joint Large-Scale Scientific Facility Funds of the NSFC and CAS under Contract Nos. 11179007, U1232201, U1332201; CAS under Contract Nos. KJCX2-YW-N29, KJCX2-YW-N45; 100 Talents Program of CAS; INPAC and Shanghai Key Laboratory for Particle Physics and Cosmology; German Research Foundation DFG under Contract No. CRC-1044; Seventh Framework Programme of the European Union under Marie Curie International Incoming Fellowship Grant Agreement No. 627240; Istituto Nazionale di Fisica Nucleare, Italy; Ministry of Development of Turkey under Contract No. DPT2006K-120470; Russian Foundation for Basic Research under Contract No. 14-07-91152; U.S. Department of Energy under Contract Nos. DE-FG02-04ER41291, DE-FG02-05ER41374, DE-FG02-94ER40823, DESC0010118; U.S. National Science Foundation; University of Groningen (RuG) and the Helmholtzzentrum fur Schwerionenforschung (GSI), Darmstadt; WCU Program of National Research Foundation of Korea under Contract No. R32-2008-000-10155-0.