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• Causal analysis of pro-cyclical behaviour of crash numbers and their driving factors. • Synthetic control method implemented for case study of financial crisis in Germany. • Crash rate fell by 8 % due to the recession. • Reduction can be attributed to 1/4 to reduced exposure and to 3/4 to reduced risk. • Driving factors were among others rurality, alcohol, speeding and driver's age. Introduction: Research suggests that recessions correlate with reductions in crash counts. However, knowledge is still scarce regarding the causality of this association, and the mechanisms through which economic shocks affect crash numbers are not well understood. We address these research gaps by applying an econometric methodology that has so far not been used for these research questions. Method: We use a quasi-natural experimental approach as our identification strategy. By exploiting the spatial heterogeneity of a shock, we define affected and less affected regions as treatment and control units. A synthetic control approach is applied to identify the causal impact of a shock on crash counts and explore the mechanisms contributing to this effect. As a case study, we use the 2008/09 financial crisis in Germany and exploit its high spatial variation. Results: We find that the crisis caused a significant crash rate reduction of 8% in the treated region. Only 1/4 of this reduction can be attributed to the decline in exposure. The remaining 3/4 are associated with the crisis-induced decrease in crash risk. Decomposing this effect shows that the crash rates in rural areas, of newly registered vehicles, of young adults, related to alcohol and speeding decline more than the overall crash rate. In contrast, crash rates of severe crashes, of heavy-goods vehicles, at night and on weekends are not the driving factors of the decrease in crash rates. Several robustness tests validate the results. Conclusions: Crash counts declined significantly due to the economic crisis. However, the magnitude of the influence is highly dependent on the crash characteristics. Practical applications: Understanding the trajectory of crash counts is crucial for implementing traffic safety measures and working towards vision zero. Our study shows that macroeconomic parameters are important potential confounding factors that should be considered in accident analysis. [ABSTRACT FROM AUTHOR]

Educational equity serves as a cornerstone for a fair and flourishing society. However, existing research consistently highlights the presence of educational disparities between developed and developing regions. Remote learning, a transformative educational approach altering knowledge dissemination and access, takes center stage. Our study delves into the potential of remote learning to bridge this educational divide. Analyzing students' performance in China's National College Entrance Examination from 2018 to 2020, we exploit the pandemic-induced shift to remote learning as an external catalyst. Employing a difference-in-differences methodology, we gage remote learning's impact on performance gaps across regions. Our findings illuminate a marked enhancement in learning outcomes for students in developing regions, surpassing their counterparts in developed ones. Furthermore, we unearth that the digital divide in access to technological resources constrains remote learning's efficacy in reducing educational disparities. Our study underscores remote learning's implications and underscores the pivotal role of digital technology capabilities. [ABSTRACT FROM AUTHOR]

Using a natural experiment of rainfall-driven remittances, we provide experimental measures of remittances' effect on rural households' choice of cylinder gas (LPG) as a cooking fuel in Bangladesh. We use the instrumental variable probit (IV-Probit) approach. The treatment of remittances is randomly assigned to households that suffered losses due to a natural shock from the cyclone-Roanu enabling the instrument to identify the average treatment effect for the treatment group (cyclone-affected remittances recipient households). We find that an exogenous increase in remittances by 1,000 Taka causes the probability of using LPG to rise by 1 percent. The impact of remittances is conditional on the household's health expenditures. Remittances' impact on the households' likelihood of using LPG gets stronger with access to clean water and sanitary toilets. The results are robust to potential violations of the exclusion restriction, alternative specifications and instruments, and possibly omitted variable bias. We recommend policies that should utilize overseas migrant remittances as a strategic tool in formulating a financial, legal, and regulatory framework to achieve SDG 7 by 2030. JEL Classifications: F24, Q40, R20. [ABSTRACT FROM AUTHOR]

Problem definition: Opportunity zones (OZs) are designated census tracts in which real estate investments can gain tax benefits. Introduced by the U.S. Tax Cuts and Jobs Act of 2017, the goal of the OZ program is to foster economic development in distressed neighborhoods. In this paper, we investigate and optimize the OZ selection process and examine the impact of OZs by exploiting two data sets: a proprietary real estate data set that includes 36.1 million residential transactions spanning all 50 U.S. states and census-tract demographics data between 2010 and 2019. Methodology/results: We show that census tracts with higher poverty and unemployment rates were more likely to be selected. Counterintuitively, however, tracts with a higher average real estate price were also more likely to be selected. We then apply difference-in-differences, synthetic control, and matching techniques to rigorously assess the impact of the OZ program on two key real estate metrics: price and transaction volume. We find that the OZ program increased real estate prices by 4.03%–6.13% but do not observe a significant effect on the transaction volume. We also find that investors primarily targeted the high-end real estate market, namely, exhibiting a cherry-picking behavior. To better fulfill its intended societal and economic goals, we propose an optimization framework with fairness considerations for OZ assignment decisions. We show that the OZs assigned from our fairness-aware optimization formulation can better serve distressed communities and mitigate investors' cherry-picking behavior. Managerial implications: Our paper underscores the importance of incorporating fairness in OZ designation to achieve a desirable real estate market reaction. Our large-scale empirical analysis provides a comprehensive assessment of the current government OZ assignment, and our fairness-aware optimization framework provides concrete recommendations for policy makers. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2024.0746. [ABSTRACT FROM AUTHOR]

The National Football League (NFL) sets its regular season schedule to optimize viewership andminimize competitive inequities.One inequity assumed to impact team performance is rest differential, defined as the relative number of days between games. Using Bayesian state space models on both game outcomes and betting market data, we estimate the competitive effect of rest differential in American football. We find that the most commonly referred to inequities--both the bye week rest advantage and the mini-bye week rest advantage--currently show no significant evidence of providing the rested team a competitive edge. Further, we trace a decline in the advantage of a bye week to a 2011 change to the NFL's Collective Bargaining Agreement, which represents a natural experiment to test the relevance of rest and preparation in football. Prior to the agreement, NFL teams off a bye week received a significant advantage (+2.2 points per game), but since 2011, that benefit has been mitigated. Our findings imply that extra days with practice time, and not extra days off alone, are the primary driver of any NFL rest advantage. [ABSTRACT FROM AUTHOR]

The need for evidence-based improvements at the workplace Work is an important social determinant of health (1). Decades of research on a wide range of different types of exposure, such as chemical, physical, biological, and psychosocial exposures at the workplace, has shown how poor working conditions are associated with adverse health outcomes and disparities in health. This has been well illustrated in the 2024 Discussion Paper series celebrating `50 years of research` in the Scandinavian Journal of Work, Environment & Health (2–9). With this rapidly increasing body of knowledge, it is quite disappointing to note that the increasing number of high-quality studies on identifying occupational risk factors are not matched by a similar number of high-quality studies aimed to design and evaluate measures that promote workers’ health and prevent work-related disease and disability (2). There is a scarcity of evidence-based workplace interventions that can guide appropriate workplace policies, programs, and practices. A linked issue is that, in situations when sufficient evidence seems available, there is a lack of urgency in utilizing research findings in the practice of occupational safety and health (OSH). A European Union report argued that, in order for research to have an impact on workers’ safety and health, there is a great need to improve the translation of OSH research findings into practice, both in the occupational health services and at workplaces (10). Both the lack of evidence-based guidance for healthy and safe workplaces as well as lack of implementation of available knowledge in practice can be partly attributed to the complexity of the workplace, given its multiple organizational levels, variety of settings and contextual factors, and required level of flexibility and adaptivity of interventions in order to be successful (11). Complex interventions require different research strategies, shifting the focus from the traditional binary question of effectiveness of a precisely defined intervention towards a broader understanding of mechanisms, processes, and outcomes of relevance to workers, companies, and OSH professionals (12). Rise and demise of the RCT Many researchers have been trained that randomized controlled trials (RCT) provide the most rigorous evidence on beneficial effects of preventive, diagnostic, and therapeutic interventions (13). With the rise of the evidence-based medicine approach, the RCT design became the gold standard, demonstrating with high quality and reliability the causal effects of the intervention. In the past 40 years, this gold standard has increasingly been critiqued and – in the era of complex system thinking and complex interventions – the status of the RCT is eroding (13,14). There is strong evidence that if evidence-based health care is limited to RCT, the evidence will favor individual-based over multicomponent interventions, highly standardized simple interventions over complex ones, and short- over long-term interventions (14). In occupational health, it has long been acknowledged that interventions often have an organizational or work environment context that hampers – or even excludes the possibility of – individual-level randomization and also makes cluster randomization very difficult (15). Very successful interventions in occupational health, eg, the introduction of a complete ban on asbestos (3) and the substitution of organic solvents in paints (4), would not have happened if knowledge from an RCT would have been the required level of evidence. Alternative study designs and research methods In recent years, there has been a big debate around which study designs are needed for a valid interpretation of an intervention`s effects. At the heart of the discussion is the inherent trade-off between causal estimation of an intervention effect and estimation of an intervention effect that matters for practice. Opinions remain strongly divided. Some researchers claim that observational studies will always be affected by bias and, thus, causal evidence can only be derived from experiments or trails emulated in observational studies (16). An experiment with randomization ensures exchangeability in that both groups are comparable for all known and unknown factors and, thus, these factors cannot bias the intervention effect. In the absence of an RCT, researchers have applied the ‘experimental causal inference’ framework to particular situations that may be interpreted as happening at random. These so-called `natural experiments` have specific statistical methods that try to ensure that the intervention of interest can be interpreted as an exogenous source (17). These natural experiment approaches include, among others, methods such as propensity-score matching, difference-in-differences, interrupted time series, instrumental variables, and regression discontinuity. An illustrative example is the introduction of a new nationwide graded return-to-work program whereby propensity-score matching demonstrated an increasing labor force participation and reduced permanent disability as a result of this intervention (18). Laaksonen and colleagues (19) used the regression discontinuity approach to show that vocational rehabilitation, assigned based on a threshold in earnings in past few years, increased paid employment, but results were far from being statistically significant. A difference-in-differences approach comparing trends before and after the introduction of a work reintegration program demonstrated reductions in the number of disability days, most notably among longer duration episodes (20). Jan Vandenbroucke and colleagues (21) have eloquently criticized this ‘causal inference’ movement, stating that truly natural experiments are rare and those that happen are usually not widely generalizable. Hence, complete reliance on natural experiments and linked statistical methods will limit much needed evidence in occupational health tremendously (22). On the other side of the spectrum, researchers argue for a paradigm shift towards more practice-relevant evidence with a system lens on multiple factors that interact in dynamic and unpredictable ways in the complex world of real data (23, 24). It is proposed to determine whether an intervention contributes, along with other factors, to a desirable outcome, acknowledging that multiple components of the intervention might each contribute to an overall beneficial effect through heterogeneous effects on disparate causal pathways (23). Such a question can often not be answered by a specific research design, but requires a myriad of new types of data, analytical methods, and interdisciplinary work (24). It will be of interest to see in the next few years whether the ‘experimentalists’ and the ‘system thinkers’ can bridge the huge gap in their appreciation of what is considered solid evidence. When is evidence strong enough to take action? Societal impact of our research requires research that matters, ie, research that provides compelling arguments to implement specific improvements in order to contribute to the health and wealth of workers and communities. Working longer in good health is an example of a key societal challenges in many countries (25), and, thus, researchers in occupational health are in the fortunate position to create societal impact by identifying determinants of healthy working-life expectancy and designing interventions that promote working longer in good health. However, this requires that scientific scrutiny for valid results does not result in postponing highly needed programs and policies in the workplace. Several articles celebrating `50 years of research` in the Journal have documented that some preventive measures have been delayed unnecessarily, sometimes in a deliberate strategy by industry to manufacture uncertainty (4, 26). Delays in taking necessary action can also be the result of scientists hesitating too long about the correct interpretation of results. A classic example is the infamous crocidolite-chrysotile asbestos debate during the 1980s and 1990s, whereby proponents of the `chrysotile is safe` argument delayed the ban on asbestos (3). In an earlier editorial, we have argued that causal inference considerations should hamper neither development nor implementation of evidence-based recommendations in occupational health when the evidence-base is reasonable (27). There are no golden rules to determine when our knowledge is sufficient to require preventive measures. I can only refer to the wise words of Sir Bradford Hill in his seminal address to the Royal Society of Medicine, describing the purpose of the newly-founded section of occupational medicine: “All scientific work is incomplete—whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us a freedom to ignore the knowledge we already have or to postpone action that it appears to demand at a given time (28)." With these words in mind, we look forward to research that provides compelling information on how to tackle the current challenges in occupational health and studies that document how this knowledge has guided successfully preventive measures at the workplace. Hopefully, we can redress the imbalance between risk-oriented research and intervention studies and create a long-lasting positive societal impact on workers’ health. References 1. Frank J, Mustard C, Smith P, et al. Work as a social determinant of health in high-income countries: past, present, and future. Lancet 2023;402:1357-67. https://doi.org/10.1016/S0140-6736(23)00871-1 2. Burdorf A, Rugulies R. Fifty years of research in the Scandinavian Journal of Work, Environment & Health. Scand J Work Environ Health 2024;50:3-10. https://doi.org/10.5271/sjweh.4135 3. Järvholm B, Burdorf A. Asbestos and disease - a public health success story? Scand J Work Environ Health 2024;50:53-60. https://doi.org/10.5271/sjweh.4146 4. Albin M, Johanson G, Hogstedt C. Successful prevention of organic solvent induced disorders: history and lessons. Scand J Work Environ Health 2024;50:135-41. https://doi.org/10.5271/sjweh.4155 5. Härmä M, Kecklund G, Tucker P. Working hours and health - key research topics in the past and future. Scand J Work Environ Health 2024;50:233-43. https://doi.org/10.5271/sjweh.4157 6. Kuijer PPFM, van der Wilk S, Evanoff B, Viikari-Juntura E, Coenen P. What have we learned about risk assessment and interventions to prevent work-related musculoskeletal disorders and support work participation? Scand J Work Environ Health 2024;50:317-28. https://doi.org/10.5271/sjweh.4172 7. Boot CRL, LaMontagne AD, Madsen IEH. Fifty years of research on psychosocial working conditions and health: From promise to practice. Scand J Work Environ Health 2024;50:395-405. https://doi.org/10.5271/sjweh.4180 8. Turner MC, Straif K, Kogevinas M, Schubauer-Berigan MK. Five decades of occupational cancer epidemiology. Scand J Work Environ Health 2024;50:489-502. https://doi.org/10.5271/sjweh.4190 9. Ropponen A, Rugulies R, Burdorf A. Towards the year 2049. The next 25 years of years of occupational health and safety research. Scand J Work Environ Health 2024;50(8):581-587. https://doi.org/10.5271/sjweh.4136 10. European Agency for Safety and Health at Work (EU-OSHA). Priorities for Occupational Safety and Health Research in Europe for the Years 2013-2020. Luxembourg: Publications Office of the European Union, 2014. 11. Skivington K, Matthews L, Simpson SA, et al. A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ 2021;374:n2061. https://doi.org/10.1136/bmj.n2061 12. Raine R, Fitzpatrick R, de Pury J. Challenges, solutions and future directions in evaluative research. J Health Serv Res Policy 2016;21:215-6. https://doi.org/10.1177/1355819616664495 13. Jones DS, Podolsky SH. The history and fate of the gold standard. Lancet 2015;385:1502-3. https://doi.org/10.1016/S0140-6736(15)60742-5 14. Bothwell LE, Greene JA, Podolsky SH, et al. Assessing the Gold Standard - Lessons from the history of RCTs. N Eng J Med 2016;374:2175-81. https://doi.org/10.1056/NEJMms1604593 15. Schelvis RMC, Oude Hengel KM, Burdorf A, et al. Evaluation of occupational health interventions using a randomized controlled trial: challenges and alternative research designs. Scand J Work Environ Health 2015;41:491-503. https://doi.org/10.5271/sjweh.3505 16. Hernán MA. Methods of public health research - strengthening causal inference from observational data. N Engl J Med 2021;385:1345-8. https://doi.org/10.1056/NEJMp2113319 17. Craig P, Katikireddi SV, Leyland A, Popham F. Natural experiments: an overview of methods, approaches, and contributions to public health intervention research. Ann Rev Public Health 2017:38:39-56. https://doi.org/10.1146/annurev-publhealth-031816-044327 18. Bethge M. Effects of graded return-to-work: a propensity-score-matched analysis. Scand J Work Environ Health 2016;42:273-9. https://doi.org/10.5271/sjweh.3562 19. Laaksonen M, Ilmakunnas I, Tuominen S. The impact of vocational rehabilitation on employment outcomes: A regression discontinuity approach Scand J Work Environ Health 2022;48:498-506. https://doi.org/10.5271/sjweh.4038 20. Macpherson RA, He A, Amick III BC, Koehoorn M, McLeod CB. Evaluating effectiveness of an integrated return-to-work and vocational rehabilitation program on work disability duration in the construction sector. Scand J Work Environ Health 2022;48:229-38. https://doi.org/10.5271/sjweh.4006 21. Vandenbroucke JP, Broadbent A, Pearce N. Causality and causal inference in epidemiology: the need for a pluralistic approach. Int J Epidemiol 2016;45:1776-86. https://doi.org/10.1093/ije/dyv341 22. Pearce N, Lawlor DA. Causal inference - so much more than statistics. Int J Epidemiol 2016;45:1895-1903. https://doi.org/10.1093/ije/dyw328 23. Greenhalgh T. Will COVID-19 be evidence-based medicine’s nemesis? PLoS Med 2020;17:e1003266. https://doi.org/10.1371/journal.pmed.1003266 24. Rod NH, Broadbent A, Rod MH, et al. Complexity in epidemiology and public health. Addressing complex health problems through a mix of epidemiologic methods and data. Epidemiology 2023;34:505-14. https://doi.org/10.1097/EDE.0000000000001612 25. Burdorf A, Cassai Pereira Fernandes R, Robroek SJW. Health and inclusive labour force participation. Lancet 2023;402:1382-92. https://doi.org/10.1016/S0140-6736(23)00868-1 26. Michaels M, Monforton C. Manufacturing uncertainty: contested science and the protection of the public’s health and environment. Am J Public Health 2005;95(suppl 1):S39-48. https://doi.org/10.2105/AJPH.2004.043059 27. Rugulies R, Burdorf A. Causal inference and evidence-based recommendations in occupational health and safety research. Scand J Work Environ Health 2020;46:554-6. https://doi.org/10.5271/sjweh.3929 28. Hill AB. The environment and disease: association or causation? Proc. Royal Soc Med 1965;58:295-300. https://doi.org/10.1177/003591576505800503

This article investigates the impact of background binaural music on educational attainment within the context of a natural experiment. In a university business school, 73 undergraduate students participated in this study, providing a maximum of 707 observations at 16 points in time. The students were divided into three groups (Microeconomics A and B, and International Economics) and were further categorized into control and experimental groups at different stages of the courses. All students attended classes from January to June 2021, with the addition of binaural music as a treatment in either the first or second part of the courses (divided into three parts). After each lecture, students completed a multiple-choice quiz designed to assess their learning during the lecture. Utilizing t-tests for mean comparisons and panel data econometric techniques, the study found that the scores of the experimental groups were significantly higher than those of the control groups. Overall, binaural music was observed to increase quiz scores by 8 to 20 basis points.

Abstract Background The Ultra-Low Emission Zone (ULEZ), introduced in Central London in April 2019, aims to enhance air quality and improve public health. The Children's Health in London and Luton (CHILL) study evaluates the impact of the ULEZ on children's health. This analysis focuses on the one-year impacts on the shift towards active travel to school. Methods CHILL is a prospective parallel cohort study of ethnically diverse children, aged 6–9 years attending 84 primary schools within or with catchment areas encompassing London’s ULEZ (intervention) and Luton (non-intervention area). Baseline (2018/19) and one-year follow-up (2019/20) data were collected at school visits from 1992 (58%) children who reported their mode of travel to school ‘today’ (day of assessment). Multilevel logistic regressions were performed to analyse associations between the introduction of the ULEZ and the likelihood of switching from inactive to active travel modes, and vice-versa. Interactions between intervention group status and pre-specified effect modifiers were also explored. Results Among children who took inactive modes at baseline, 42% of children in London and 20% of children in Luton switched to active modes. For children taking active modes at baseline, 5% of children in London and 21% of children in Luton switched to inactive modes. Relative to the children in Luton, children in London were more likely to have switched from inactive to active modes (OR 3.64, 95% CI 1.21–10.92). Children in the intervention group were also less likely to switch from active to inactive modes (OR 0.11, 0.05–0.24). Moderator analyses showed that children living further from school were more likely to switch from inactive to active modes (OR 6.06,1.87–19.68) compared to those living closer (OR 1.43, 0.27–7.54). Conclusions Implementation of clean air zones can increase uptake of active travel to school and was particularly associated with more sustainable and active travel in children living further from school.

Abstract Purpose Non-pharmaceutical interventions (NPIs) have been the cornerstone of COVID-19 pandemic control, but evidence on their effectiveness varies according to the methods and approaches taken to empirical analysis. We analysed the impact of NPIs on incident SARS-CoV-2 across 32 European countries (March-December 2020) using two NPI trackers: the Corona Virus Pandemic Policy Monitor – COV-PPM, and the Oxford Covid-19 Government Response Tracker – OxCGRT. Methods NPIs were summarized through principal component analysis into three sets, stratified by two waves (C1-C3, weeks 5–25, and C4-C6, weeks 35–52). Longitudinal, multi-level mixed-effects negative binomial regression models were fitted to estimate incidence rate ratios for cases and deaths considering different time-lags and reverse causation (i.e. changing incidence causing NPIs), stratified by waves and geographical regions (Western, Eastern, Northern, Southern, Others). Results During the first wave, restrictions on movement/mobility, public transport, public events, and public spaces (C1) and healthcare system improvements, border closures and restrictions to public institutions (C2) were associated with a reduction in SARS-CoV-2 incidence after 28 and 35-days. Mask policies (C3) were associated with a reduction in SARS-CoV-2 incidence (except after 35-days). During wave 1, C1 and C2 were associated with a decrease in deaths after 49-days and C3 after 21, 28 and 35-days. During wave 2, restrictions on movement/mobility, public transport and healthcare system improvements (C5) were also associated with a decrease in SARS-CoV-2 cases and deaths across all countries. Conclusion In the absence of pre-existing immunity, vaccines or treatment options, our results suggest that the observed implementation of different categories of NPIs, showed varied associations with SARS-CoV-2 incidence and deaths across regions, and varied associations across waves. These relationships were consistent across components of NPIs derived from two policy trackers (CoV-PPM and OxCGRT).

Background: The Ultra-Low Emission Zone (ULEZ), introduced in Central London in April 2019, aims to enhance air quality and improve public health. The Children's Health in London and Luton (CHILL) study evaluates the impact of the ULEZ on children's health. This analysis focuses on the one-year impacts on the shift towards active travel to school. Methods: CHILL is a prospective parallel cohort study of ethnically diverse children, aged 6–9 years attending 84 primary schools within or with catchment areas encompassing London's ULEZ (intervention) and Luton (non-intervention area). Baseline (2018/19) and one-year follow-up (2019/20) data were collected at school visits from 1992 (58%) children who reported their mode of travel to school 'today' (day of assessment). Multilevel logistic regressions were performed to analyse associations between the introduction of the ULEZ and the likelihood of switching from inactive to active travel modes, and vice-versa. Interactions between intervention group status and pre-specified effect modifiers were also explored. Results: Among children who took inactive modes at baseline, 42% of children in London and 20% of children in Luton switched to active modes. For children taking active modes at baseline, 5% of children in London and 21% of children in Luton switched to inactive modes. Relative to the children in Luton, children in London were more likely to have switched from inactive to active modes (OR 3.64, 95% CI 1.21–10.92). Children in the intervention group were also less likely to switch from active to inactive modes (OR 0.11, 0.05–0.24). Moderator analyses showed that children living further from school were more likely to switch from inactive to active modes (OR 6.06,1.87–19.68) compared to those living closer (OR 1.43, 0.27–7.54). Conclusions: Implementation of clean air zones can increase uptake of active travel to school and was particularly associated with more sustainable and active travel in children living further from school. [ABSTRACT FROM AUTHOR]

This article investigates the impact of background binaural music on educational attainment within the context of a natural experiment. In a university business school, 73 undergraduate students participated in this study, providing a maximum of 707 observations at 16 points in time. The students were divided into three groups (Microeconomics A and B, and International Economics) and were further categorized into control and experimental groups at different stages of the courses. All students attended classes from January to June 2021, with the addition of binaural music as a treatment in either the first or second part of the courses (divided into three parts). After each lecture, students completed a multiple-choice quiz designed to assess their learning during the lecture. Utilizing t-tests for mean comparisons and panel data econometric techniques, the study found that the scores of the experimental groups were significantly higher than those of the control groups. Overall, binaural music was observed to increase quiz scores by 8 to 20 basis points. [ABSTRACT FROM AUTHOR]

Background: Globally alcohol consumption is a leading risk factor for premature death and disability and is associated with crime, social and economic consequences. Local communities may be able to play a role in addressing alcohol-related issues in their area. Objectives: To evaluate the effectiveness and cost–benefit of an asset-based community development approach to reducing alcohol-related harm and understand the context and factors that enable or hinder its implementation. Design: A mixed-methods evaluation. Area-level quasi-experimental trial analysed using four different evaluation methods (a stepped-wedge design where each area was a control until it entered the intervention, comparison to matched local/national controls and comparison to synthetic controls), alongside process and economic evaluations. Setting: Ten local authorities in Greater Manchester, England. Participants: The outcomes evaluation was analysed at an area level. Ninety-three lay persons representing nineareas completed questionnaires, with 12 follow-up interviews in five areas; 20 stakeholders representing ten areas were interviewed at baseline, with 17 follow-up interviews in eight areas and 26 members of the public from two areas attended focus groups. Interventions: Professionals in a co-ordinator role recruited and supported lay volunteers who were trained to become alcohol health champions. The champion's role was to provide informal, brief alcohol advice to the local population and take action to strengthen restrictions on alcohol availability. Main outcome measures: Numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs, street-level crime and antisocial behaviour in the intervention areas (area size: 1600–5500 residents). Set-up and running costs were collected alongside process evaluation data exploring barriers and facilitators. Data sources: Routinely collected quantitative data on outcome measures aggregated at the intervention area and matched control and synthetic control areas. Data from policy documents, licensing registers, meeting notes, invoices, time/cost diaries, training registers, questionnaires, interviews, reflective diaries and focus groups. Results: The intervention rolled out in nine out of ten areas, seven of which ran for a full 12 months. Areas with better-established infrastructure at baseline were able to train more champions. In total, 123 alcohol health champions were trained (95 lay volunteers and 28 professionals): lay volunteers self-reported positive impact. Champions engaged in brief advice conversations more readily than taking action on alcohol availability. There were no consistent differences in the health and crime area-level indicators between intervention areas and controls, as confirmed by using three different analysis methods for evaluating natural experiments. The intervention was not found to be cost-beneficial. Limitations: Although the sequential roll-out order of the intervention was randomised, the selection of the intervention areas was not. Self-reported impact may have been subject to social desirability bias due to the project's high profile. Conclusions: There was no measurable impact on health and crime outcomes. Possible explanations include too few volunteers trained, volunteers being unwilling to get involved in licensing decisions, or that the intervention has no direct impact on the selected outcomes. Future work: Future similar interventions should use a coproduced community outcomes framework. Other natural experiment evaluations should use methodological triangulation to strengthen inferences about effectiveness. Trial registration: This trial is registered as ISRCTN81942890. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information. Plain language summary: What was the question?: Alcohol consumption puts an individual's health and social relationships at risk of harm. The more a person drinks, the more harmful it is. The harmful effects can place a burden on emergency services and hospitals. We wanted to find out whether community members can make a difference by taking action to address alcohol harm in their local area. What did we do?: Local councils in Greater Manchester developed a project called Communities in Charge of Alcohol, where volunteers in targeted local areas were trained to become 'alcohol health champions'. Alcohol health champions gave alcohol-related brief advice to people to help them drink less. They had a say about when, where and how alcohol is sold by reporting issues to their local council. We compared numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs and reports of crime and antisocial behaviour between areas that had alcohol health champions with other similar areas in England that did not. We calculated how much it costs to run and whether Communities in Charge of Alcohol could save society money. What did we find?: Not as many volunteers came forward to become an alcohol health champion as hoped for. Those who did give alcohol-related brief advice to people. They preferred not to report issues about alcohol sales to their local council, either because it was too complicated or because they did not want to be called a 'grass'. We did not find levels of alcohol harm changed in the Communities in Charge of Alcohol areas. Because of this, we could not demonstrate that Communities in Charge of Alcohol could save society money. What does this mean?: Getting involved in alcohol licensing decisions needs to be made easier for communities, with more anonymity, through the support of professionals. More work needs to be done to understand whether giving brief advice can reduce alcohol harm in whole communities. Scientific summary: Background: The availability of, and access to, alcohol is a key determinant of alcohol harm, and powers exist within the Licensing Act 2003 of England and Wales that enable the public to influence the local sale and supply of alcohol. At an individual level, implementing programmes to promote early risk identification and brief advice have the potential to reduce alcohol consumption and prevent alcohol-related harm, but there is a dearth of evidence to determine the feasibility and effectiveness of lay people having a role. The Greater Manchester (GM) Combined Authority (GMCA) and Greater Manchester Health and Social Care Partnership (GMHSCP) designed a new programme, 'Communities in Charge of Alcohol' (CICA) in 2017 to train lay volunteers to become alcohol health champions (AHCs), who would be able to (1) give alcohol-related brief advice to individuals and (2) help communities influence alcohol availability and strengthen restrictions in alcohol risk environments. Overall aims: To evaluate the effectiveness and cost–benefit of implementing a locally delivered AHC intervention and understand the context and factors that enable or hinder the intervention. Objectives: Relating to the outcome evaluation: to determine the effect on area-level key health performance indicators: alcohol-related hospital admissions (narrow measure), weekend accident and emergency (A&E) attendances (Friday 3 p.m.–Sunday 3 p.m.), weekday A&E attendances (Monday–Friday 9 a.m.–5 p.m. each day), weekend ambulance call-outs (Friday 3 p.m.–Sunday 3 p.m.), weekday ambulance call-outs (Monday–Friday 9 a.m.–5 p.m. each day) to determine the effect on key crime indicators (street-level crime data) at the weekend (Friday 3 p.m.–Sunday 3 p.m.) and weekday (Monday–Friday 9 a.m.–5 p.m. each day) to determine the effect on key antisocial behaviour (ASB) indicators (police recorded calls for service were classified as ASB according to the National Standard for Incident Recording). Relating to the process evaluation: to explore policy context and variation in licensing practice, including any impact of devolution in GM to explore barriers and facilitators at key stages of the implementation of the intervention: recruitment of AHCs to initial training and cascade training, delivery of initial training and cascade training, use of skills beyond the training in AHC activity, retention of AHCs to explore responses to AHC training, modelling of health behaviours, perceptions of community cohesion and development to determine numbers of brief interventions applied and community awareness events organised/participated in to examine and quantify the amount and success of community involvement in licensing issues to determine whether there was a change in composite measures of alcohol availability. Relating to the economic evaluation: to identify set-up and running costs using a standardised costing exercise to resolve costs by sector (health, ambulance and police) before, during and after set-up to quantify benefits due to reduced hospital admissions, ambulance call-outs, A&E use, crime and ASB. Methods: Communities in Charge of Alcohol was a complex intervention already planned by the GMCA in 10 small local authority areas (~1600–5500 residents each) and was outside direct researcher control. Intervention areas were chosen by each local authority public health team as having high levels of alcohol harm in comparison to the rest of the local authority. All intervention areas were at the bottom of the deprivation index, in deprivation decile 1 or 2. Using a stepped-wedge design, researchers were able to randomise the order of roll-out of intervention areas to bring a quasi-experimental approach to the evaluation. Two additional evaluation designs were used in order to triangulate findings, namely comparison to matched controls and comparison to synthetic controls. Ethical approval was received from the University of Salford Research Ethics Committee on 17 May 2017 (reference number: HSR1617–135) and obtained from the University of Bristol on 16 May 2019 (reference number: 82762). Outcome evaluation data sources: Routinely collected data at the lower-layer super output area (LSOA) level for intervention areas was compared with control areas. Data sources were as follows: alcohol-related hospital admissions data – Public Health England (now Office for Health Improvement and Disparities) accident and emergency department attendance data – NHS Digital ambulance call-out data – North West Ambulance Service reported crime and ASB data – GM Police. Analysis spanned a 10-year period (7 years pre intervention and a maximum of 3 years post implementation), ending in January 2020. Data were analysed using log-rate growth models and time series analyses to quantify the effect of the CICA programme on key performance indicators. Process evaluation data sources: Pre-implementation phase document review of local Statements of Licensing Policy (n = 9), alcohol availability composite score of on- and off-licensed premises (n = 9 areas), roll-out preparatory meeting notes. Train-the-Trainer attendance registers by area (n = 5, representing 9 areas, attended by 48 lay participants and 25 professional participants). Cascade training attendance registers by area (n = 11, representing 7 areas, attended by 47 lay participants and 3 professional participants). Pre- and post-training questionnaires (n = 93 lay people, 98% response rate). Baseline interviews with stakeholders (n = 20) (initial implementation phase); interviews with lay volunteer AHCs (n = 5, representing 3 areas) within 3–6 months of initial training (implementation phase). Follow-up interviews (12 months) with stakeholders (n = 11, representing eight areas), licensing officers (n = 6, representing six areas) and lay volunteer AHCs (n = 7, representing four areas); follow-up questionnaires with AHCs (n = 11); focus groups with local residents (n = 3 groups, representing two areas, with a total of 26 participants). Economic evaluation data sources: Time and transportation costs incurred during project meetings aggregated from meeting minutes and stakeholder time/cost diaries. Invoices for the design, development and delivery of training packages and accreditation fees. Invoices for the qualification and assessment fees, time and miscellaneous (transportation, room hire, catering, printing costs). AHC time and costs aggregated from volunteer diaries and stakeholder time/cost diaries. Invoices for engagement materials (AUDIT-C scratchcards). Greater Manchester Combined Authority research team's (formerly New Economy) cost–benefit analysis (CBA) tool was populated using aggregated outcome evaluation data to resolve costs for each key performance indicator before, during and after CICA setup. Results: Nine out of 10 local authorities rolled out the CICA intervention on their given start date: seven areas completed a full year, carrying out cascade training in the first 12 months, two areas withdrew at 6 and 9 months and one area withdrew in the pre-implementation phase. There were 118 [interquartile range (IQR): 60–205] alcohol-related hospital admissions per month per pre-intervention LSOA , rising to 134 (IQR : 67–203) post intervention. Some outcomes had very small counts at the LSOA level; notably, there were only 2 (IQR : 1–3) weekend crimes per month pre-intervention and 4 (IQR : 2–6) post intervention. The primary, stepped-wedge analyses provide weak evidence of an average increase in alcohol-related hospital admissions following the implementation of CICA of about 13%, corresponding to about 20 admissions weekly, although the confidence interval was wide, −1.98 to 31.39, and not statistically significant (p~0.09), while the analysis that made use of local controls suggested a bigger effect, at 16.4% (7.33–26.16, p < 0.001). However, the other methods of analysis (national controls and counterfactuals) indicated much smaller effect sizes and confidence intervals, including unity: 3.42% (−4.56 to 12.07; p = 0.41) and 7.14% (−9.76 to 24.04; p = 0.41), respectively. The other quantitative outcomes (A&E admissions, or ambulance call-outs to the area, nor to reported crimes or reported ASB incidents) showed some were individual statistically significant effects (with some methods and some indicators), but these were more often not in favour of the intervention. Triangulation of three methods of analysis did not indicate any consistent differences between control and intervention areas. The pre-implementation phase was defined as the period leading up to the roll-out of the first Train-the-Trainer event. Several facilitating contextual factors were identified a priori. The total number of these factors in place at baseline correlated with numbers trained in the first year (Rs = 0.77, p = 0.01). Specifically, areas with a healthcare provider to co-ordinate the intervention (p = 0.02); a pool of other volunteers to recruit from (p = 0.02); a contract in place with a commissioned service (p = 0.02); and formal volunteer arrangements (p = 0.03) trained more AHCs. Across all nine areas, fewer volunteers were recruited than the anticipated target of 35 per area. In total, 123 AHCs were trained and gained a Royal Society for Public Health Level 2 qualification. Of these, 95 were lay volunteers from the intervention areas. The majority identified as white (70%), with ages ranging from 18 to 65+, and almost half aged between 41 and 60 (48%). Slightly more women volunteered compared to men (61%). Most AHCs self-reported being in the lower-risk drinking category (66% scored 0–4 on AUDIT-C). Post-training questionnaires suggested that volunteers felt more confident to talk about the harms associated with alcohol and give alcohol-related brief advice than they did pre training (91.4% compared with 79.6%, p < 0.001) and that they felt more confident to raise issues about venues selling alcohol (90.3% compared with 74.2% pre training, p < 0.001). Intervention areas that recorded AHC activity (n = 5) captured 1100 conversations, 251 AUDIT-Cs completed and 65 community events attended. Time/cost diaries suggested that AHCs spent on average 11 minutes having an informal brief advice conversation. Interviews with AHCs on self-reported activity were consistent with time/cost and reflective diaries: AHCs put into practice brief advice conversations more than community action to influence licensing. Interviews with stakeholders indicated several enabling factors to consider when rolling out and embedding an AHC intervention: a clear understanding of the place-based focus; commissioned provider services needing a clear understanding of own roles and the anticipated outcomes; and co-ordinators having the skills and capacity to support inexperienced volunteer groups. The importance of infrastructure was reflected in interviews, recognising that preparing the ground at a hyperlocal level takes time, needing to be well in advance of the formal implementation period. Recruitment strategies need to be multipronged, and stakeholders need to be prepared to provide a sustained period of support for new and existing champions. In the follow-up phase, 12 months post intervention, interviews with stakeholders revealed how the local co-ordinators' ability to operationalise and sustain CICA was significantly impacted by their lack of capacity to sustain the levels of support, as well as the complexity of skills required of the role. After 12 months, there was strong consistency in findings from follow-up interviews with stakeholders, AHCs and focus groups with members of the public. Communities in Charge of Alcohol's intended mechanism of action was to reduce alcohol-related harm through secondary prevention interventions; however perceptions of those most in need of an AHC conversation were 'problem drinkers' to signpost into tertiary interventions. Quality of local alcohol treatment services was considered to be poor, with multiple barriers to help and information seeking. Conclusions: To our knowledge, CICA is the first alcohol-focused champion role of its kind to be investigated and across multiple intervention sites. It is also the first evaluation of a health champion programme that uses methodological triangulation to strengthen inferences about effectiveness. There was evidence that lay people trained as AHCs were able to have conversations with members of their communities who were consuming alcohol at higher risk levels, demonstrating a level of skill and confidence that can sometimes be absent in health professionals. AHCs, their co-ordinators and the public valued the role. However, significant infrastructure is needed to support an intervention such as CICA , and time is needed to develop and embed a group of volunteers. Despite evidence (from the process evaluation) of the planned activity taking place at local level, we were not able to show that CICA was effective, nor was it cost-effective. There are likely to be two main reasons for this. Firstly, the number of champions trained was too small to have a sufficient number of brief advice conversations to generate any measurable effect at the area level of analysis. Moreover, brief interventions may not directly impact on primary health and crime outcomes at a population level. Secondly, the AHCs were less willing (and had less opportunity) to get involved with alcohol licensing decisions. Since licensing policies theoretically have an impact at an area level, this theoretically would have been more likely to generate a significant area-level effect. The evidence from this study is that communities continue to struggle to influence statutory processes that affect alcohol availability where they live, and further consideration of how to enable increased community engagement is necessary. Recommendations for future research (numbered in priority order): natural experiment evaluations should include methodological triangulation to guard against overinterpretation of spurious results investigate coproducing a community outcomes framework to measure reductions in alcohol harm evaluate whether rebalancing local licensing policy to be community-centred might increase community engagement in the local licensing decision-making process investigate the effectiveness of CICA in areas where indicators of alcohol harm are increasing but are not at the highest level of harm within the local authority a wider range of external contextual factors could be tested in the pre-implementation phase of a complex intervention, incorporating methods to combine factors into mean scores, to test relationships between process indicators and outcomes. Trial registration: This trial is registered as ISRCTN81942890. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information. [ABSTRACT FROM AUTHOR]

This paper investigates the ramifications of information feed integration on user engagements and contributions in online content-sharing platforms by exploiting a natural experiment occurred in a leading knowledge-sharing platform that integrated informal social posts with professional knowledge content in one feed. Our results show that the juxtaposition of incongruous types of content increased mindset switching and cognitive strain, thus hurting user engagements. We also reveal a novel crowding-out effect, viz., the integration heightened concerns that posting informal social posts would dilute the contributor's professional image, thus inhibiting user contributions. Our findings hold important practical implications for all platforms that host (or are considering hosting) diverse types of user-generated content (UGC). Additional content curation tools can potentially enhance user engagement and retention, but their effectiveness hinges on a foundational and crucial element—the presentation format of heterogeneous content types. Essentially, the value of curating informal social posts in a knowledge-sharing platform would diminish when those content intrudes upon and conflict with the professional domain. This insight underscores that any UGC platforms, when adopting a diversity-oriented strategy, should pay close attention to heterogeneity between different content types for the purpose of optimizing user experiences and promoting user contributions. Many online communities that rely on effortful, voluntary content contributions offer additional content curation tools to facilitate social interactions and encourage user contributions. Any platform that offers two or more heterogeneous content types (e.g., expert knowledge and social posts) faces a choice about the presentation format: whether to display the content types separately or in an integrated information feed. We leverage a natural experiment on Zhihu, a Q&A platform that offers a social-interaction-oriented functionality called Ideas. Zhihu initially presented answers (expert knowledge content) and ideas (social posts) in two different information feeds, but the platform integrated ideas into the same information feed as answers in June 2019. We find that information feed integration significantly decreased user engagement with and contribution of both ideas and answers. We hypothesize that users decreased their engagement because the juxtaposition of incongruous types of content increased mindset switching and cognitive strain. This hypothesis is supported by an additional laboratory experiment. We also present evidence showing that contributions decreased both because of the decrease in engagement (weaker social recognition incentives) and because integration heightened concerns that posting ideas would dilute the contributor's professional image. Our findings have important theoretical and practical implications for any platform that hosts heterogeneous content. History: Xiaoquan (Michael) Zhang served as the senior editor and Yili (Kevin) Hong served as associate editor for this article. Funding: Z. Cao acknowledges this research was funded by National Natural Science Foundation of China [Grants 72201238, 72192823]. G. Li acknowledges this research was funded by National Natural Science Foundation of China [Grant 72102047] and Shanghai Pujiang Program [Grant 21PJC006]. Supplemental Material: The e-companion is available at https://doi.org/10.1287/isre.2022.0043. [ABSTRACT FROM AUTHOR]

Live oyster reefs are considered a critical recruitment habitat for estuarine faunal populations as localized in situ or mesocosm studies have demonstrated many faunal species prefer live oyster habitat. It has therefore been assumed that the loss of live oyster habitat would precipitate faunal population declines, but this has been largely untested at large (estuary) scales. Here, we assessed how estuary‐wide faunal populations were affected by a 95% loss of live oyster habitat following the 2012 oyster collapse of Apalachicola Bay, FL, which previously supported one of the largest oyster fisheries in the United States. We standardized long‐term fisheries‐independent monitoring seine and trawl data to create relative indices of resident, associated, and transient faunal species' overall abundance and recruit abundance (restrictive to sizes between 15% and 35% of L∞$$ {L}_{\infty } $$). We expected that both relative abundance indices would decrease following the oyster collapse, particularly among species that reside on or recruit to oyster reefs. However, analyses via a series of one‐sided Bayesian t tests did not indicate that faunal recruitment or overall abundance significantly declined in 2012 post‐collapse. As the response of the faunal population could be lagged relative to the 2012 collapse, we also conducted change point analyses to search for lagged declines. Of the 24 relative abundance time series, only two had significant change points post‐collapse, and only black sea bass overall relative abundance declined with an associated change point at the end of the time series. The surprising paucity of faunal decline following oyster loss may be due to the use of alternative habitat types, exceptionally lagged faunal responses, or, perhaps most compelling, a disconnect between preferred and required habitats. Our failure to detect faunal consequences following an oyster population collapse suggests that assumptions of habitat loss (or restoration) effects on estuarine fauna at ecosystem scales are not straightforward and the extrapolation of sub‐estuary‐scale studies may result in poor predictions of future outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Recent years have witnessed an increase in highly publicized attacks targeting members of ethnoracial and religious minority groups. To date, existing research has primarily focused on the tendency for such "trigger events" to generate violent aftershocks. We argue that beyond such ripple effects, highly salient trigger events significantly increase hate-crime related stress among racial and ethnic minorities. Additionally, we explore whether these effects are limited to the group most clearly targeted, or if they "spill over" to other minoritized communities. Methods: To study reactions to hate crimes, we draw upon national survey data (N = 1,122) in combination with a natural experiment involving the Unite the Right rally and vehicle attack in Charlottesville, Virginia in August 2017. We employ an "unexpected event during survey" design to estimate the causal effect of the Charlottesville rally on stress about hate crimes. Results: We first show that there was an increase in anti-Black hate crimes in the 2 weeks following the Charlottesville incident. We also find a corresponding increase in stress due to the perception of personal vulnerability to hate crimes among African-Americans. However, we do not observe a significant increase in levels of stress following the trigger event among Hispanics and Asian Americans. Discussion: Our results suggest that highly publicized instances of intergroup violence can have significant impacts on stress about hate crime victimization within the target group. However, we find that this effect is short-lived, and that both violent aftershocks and the general climate of fear spurred by hate crimes may be racially bounded. [ABSTRACT FROM AUTHOR]

As disasters increase due to climate change, population density, epidemics, and technology, information is needed about postdisaster consequences for people's mental health and how stress-related mental disorders affect multiple spheres of life, including labor-market attachment. We tested the causal hypothesis that individuals who developed stress-related mental disorders as a consequence of their disaster exposure experienced subsequent weak labor-market attachment and poor work-related outcomes. We leveraged a natural experiment in an instrumental variables model, studying a 2004 fireworks factory explosion disaster that precipitated the onset of stress-related disorders (posttraumatic stress disorder, anxiety, and depression) among individuals in the local community (N = 86,726). We measured labor-market outcomes using longitudinal population-level administrative data: sick leave, unemployment benefits, early retirement pension, and income from wages from 2007 to 2010. We found that individuals who developed a stress-related disorder after the disaster were likely to go on sickness benefit, both in the short-and long-term, were likely to use unemployment benefits and to lose wage income in the long term. Stress-related disorders did not increase the likelihood of early retirement. The natural experiment design minimized the possibility that omitted confounders biased these effects of mental health on work outcomes. Addressing the mental health and employment needs of survivors after a traumatic experience may improve their labor-market outcomes and their nations' economic outputs. [ABSTRACT FROM AUTHOR]

A natural experiment reveals that an ad ban reduces sales of a grocery retailer by 6% but does not affect overall market size. Advertising bans typically target products that deceive consumers in ways that can threaten their physical and mental health. An alternative policy objective might seek environmental protection through a ban on print advertising. Such measures would profoundly affect grocery retailers relying on printed leaflets to communicate weekly promotions. We measure the causal effect of banning advertising on retail performance by studying a temporary advertising ban implemented in a German federal state during the COVID-19 pandemic. The ban resulted in the suspension of all print advertising by grocery retailers, and the exogenous variation in advertising created by this natural experiment serves as our identification strategy. We apply difference-in-differences regressions to data from a national grocery retailer and find that the ban resulted in a 6% sales decrease in the treated state compared with an adjacent state. GfK Household Panel data reveal no effect of the advertising ban on the market level but a negative impact on retailers offering and advertising weekly promotional product assortments. We study the sensitivity of these results to the COVID pandemic and find that neither changes in COVID-19 incidence, vaccination rates, nor customers' mobility moderate the ad ban effect. The findings offer practical insights for regulators and retailers regarding the impact of ad bans and the value of advertising. History: Catherine Tucker served as the senior editor for this article. This paper was accepted through the Marketing Science: Frontiers review process. Conflict of Interest Statement: None of the authors have any financial or non-financial interests in this manuscript's subject matter or materials. Sebastian Gabel consults with a company linked to the retailer that provided the data. Access to the GfK Household Panel data is provided by AiMark (http://www.aimark.org), which is a not-for-profit foundation that supports top academic research with scanner data provided by its data partners GfK and Kantar. Funding: This work was supported by Deutsche Forschungsgemeinschaft (CRC TRR 190 [Project Number 280092119]) and Nederlandse Organisatie voor Wetenschappelijk Onderzoek. S. Gabel acknowledges funding from the Dutch Research Council (NWO) under a Veni grant. M. Spann acknowledges funding from the German Research Foundation. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mksc.2023.0019. [ABSTRACT FROM AUTHOR]

Population-level efforts are needed to increase levels of physical activity and healthy eating to reduce and manage chronic diseases such as obesity, cardiovascular disease, and type 2 diabetes. Interventions to increase public transit use may be one promising strategy, particularly for low-income communities or populations of color who are disproportionately burdened by health disparities and transportation barriers. This study employs a natural experiment design to evaluate the impacts of a citywide zero-fare transit policy in Kansas City, Missouri, on ridership and health indicators. In Aim 1, comparison to 9 similar cities without zero-fare transit is used to examine differential changes in ridership from 3 years before to 4 years after the adoption of zero-fare. In Aim 2, Kansas City residents are being recruited from a large safety net health system to compare health indicators between zero-fare riders and non- riders. Longitudinal data on BMI, cardiometabolic markers, and economic barriers to health are collected from the electronic health record from 2017 to 2024. Cross-sectional data on healthy eating and device-measured physical activity are collected from a subsample of participants as part of the study procedures (N = 360). Numerous baseline characteristics are collected to account for differences between Kansas City and comparison city bus routes (Aim 1) and between zero-fare riders and non-riders within Kansas City (Aim 2). Evidence on how zero-fare transit shapes population health through mechanisms related to improved economic factors, transportation, physical activity, and healthy eating among low-income groups is expected.

The National Football League (NFL) sets its regular season schedule to optimize viewership and minimize competitive inequities. One inequity assumed to impact team performance is rest differential, defined as the relative number of days between games. Using Bayesian state space models on both game outcomes and betting market data, we estimate the competitive effect of rest differential in American football. We find that the most commonly referred to inequities—both the bye week rest advantage and the mini-bye week rest advantage— currently show no significant evidence of providing the rested team a competitive edge. Further, we trace a decline in the advantage of a bye week to a 2011 change to the NFL's Collective Bargaining Agreement, which represents a natural experiment to test the relevance of rest and preparation in football. Prior to the agreement, NFL teams off a bye week received a significant advantage (+2.2 points per game), but since 2011, that benefit has been mitigated. Our findings imply that extra days with practice time, and not extra days off alone, are the primary driver of any NFL rest advantage.

Background and objectives Schools play a crucial role in facilitating physical activity among children, but the COVID-19 pandemic has affected both children’s physical activity and the school environment. It is essential to understand between-school differences in children’s physical activity post lockdown, to determine if and how the role of schools has changed. Design and participants Active-6 is a natural experiment comparing postlockdown accelerometer-estimated physical activity to a pre-COVID-19 comparator group. Accelerometer and individual data were collected on 1296 children aged 10–11 pre-COVID-19 (2017–8), with school characteristics collected from the 50 schools they attended. Post lockdown, we collected accelerometer, individual and school data from 393 children in 23 of the same schools and 436 children in 27 of the same schools in 2021 (Wave 1) and 2022 (Wave 2), respectively. Methods Sources of variation (between-school, between-pupil and within-pupil) in child weekday moderate to vigorous physical activity at each wave were modelled using linear mixed-effects models with school-level wave random coefficients. We extended the model to estimate the proportion of between-school variation explained by school policy, curriculum and physical environment factors and school-aggregated pupil characteristics. We also explored the extent to which postlockdown differences in moderate to vigorous physical activity were mediated by individual or school factors. Results Between-school variation comprised 13% of the total variation pre-COVID-19, 7% in Wave 1 and 13% in Wave 2. School factors associated with moderate to vigorous physical activity were the following: whether physical education was compromised due to space (often: 9 minutes lower moderate to vigorous physical activity; sometimes: 5.4 minutes lower); high after-school club attendance (7 minutes higher moderate to vigorous physical activity for each additional club attended on average in the school); cycle training policy (4 minutes higher moderate to vigorous physical activity); and higher prevalence of active travel (1 minute higher moderate to vigorous physical activity for each 10% point increase in prevalence). These factors explained 22% of the between-school variation pre-COVID-19, and 72% at Wave 2. The relative importance changed, with cycle training policy and active travel being the most important pre-COVID-19 and cycle training policy, active after-school clubs and compromised physical education space most important in Wave 2. No factors were found to mediate the postlockdown differences in moderate to vigorous physical activity, except compromised physical education space, which had a suppressor effect in Wave 2. Limitations Only 27 of the initial 50 schools participated post lockdown, limiting our ability to make comparisons across waves. Sample sizes were additionally affected by missing data for some variables. Conclusions and future work While schools continue to play an important role in facilitating children’s physical activity, the factors that contribute to this have changed post-COVID-19, with cycle training, active after-school clubs and ensuring physical education is prioritised even when space is limited now explaining nearly three-quarters of the between-school variation in children’s moderate to vigorous physical activity. School-level interventions that focus on these areas, and policies that support them, may offer the potential to increase children’s physical activity. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847. Plain language summary What was the question? Schools are important in helping children to be physically active. How active children are differs between schools. We wanted to know whether this has changed after the COVID-19 lockdowns. We also looked at features of the school, like equipment in the playground or being active in lessons, that might explain these differences. What did we do? We collected activity data from 10- to 11-year-olds from 50 schools around Bristol (United Kingdom) before and after the COVID-19 lockdowns. Children also told us about how they travelled to school and whether they went to after-school sports or exercise clubs. We asked schools about their policies and lessons. Finally, we collected data on the playground and surroundings. What did we find? In the first 6 months after lockdowns, schools had a much smaller role in children’s activity. But after a year, schools were once again an important influence on how active children were. We found that the school features that affected children’s activity had changed. Before the pandemic, the things that helped children most to be active were learning to ride a bike at school, and walking or cycling to school. After the pandemic, offering lots of after-school sports clubs was more important. Schools that struggled with physical education lessons because of a lack of space had fewer active pupils. What does this mean? Schools continue to play an important role in helping children be active. But this role has changed after the lockdowns. In the future, schools could help keep children active by offering plenty of after-school clubs and help children to learn to ride a bike. Also, it is important to make sure that physical education lessons are a priority, even when there is not much space.

Abstract Background Regulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world’s first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils. Methods With a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status. Results Longitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings. Conclusions This regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere.

Sociology has recently seen a surge of interest in implicit culture, which refers to knowledge, habits, and feelings that are largely automatic and habitual. In this article, I argue that certain expressions of implicit culture may be more contextual and malleable than previously thought. The argument is illustrated by showing how terror attacks in France affect implicit bias toward Arab Muslims. By analyzing the longevity and specificity of this effect, I also detail when and why implicit bias might change. The article consists of two studies. Study 1 shows that the attacks significantly increased implicit bias in France (n = 449), whereas Study 2 shows that the attacks had a similar effect globally (n = 25795). There was no corresponding effect on explicit bias in either study. I discuss the implications of the findings for research on terror attacks, implicit bias, and implicit culture.

ObjectivesNeighborhood disadvantage may increase the risk of adverse health outcomes among older refugees. Yet few studies rigorously estimate the effects of place-based factors on later-life health, particularly dementia and mortality. Evidence about refugees is especially sparse.MethodsThis study leveraged a natural experiment in the form of a Danish policy (1986-1998) that dispersed refugees quasi-randomly across neighborhoods upon arrival. We used longitudinal registers allowing 30 years of follow-up among refugees aged 40+ years upon arrival in Denmark (N = 9,854). Cox models assessed the association between neighborhood disadvantage and risk of dementia and mortality. We examined heterogeneous effects by sex, age, and family size. We also examined associations among non-refugee immigrants and native-born Danes.ResultsNeighborhood disadvantage was not associated with dementia in any group. One unit increase in neighborhood disadvantage index (ranges -8 to 5.7) was associated with greater mortality risk among non-refugee immigrants (HR 1.06, 95%CI: 1.02, 1.10) and native-born Danes (HR 1.11, 95%CI: 1.06, 1.17). In contrast, neighborhood disadvantage was associated with lower mortality risk among refugees (HR 0.96, 95%CI: 0.93, 0.99). Neighborhood disadvantage remained negatively associated with mortality risk in subgroups: refugees who are female (on moderate-disadvantage compared to low-disadvantage), aged 60+, and who arrived with families.DiscussionWhile neighborhood disadvantage was associated with lower mortality risk among refugees, it was associated with greater mortality risk among non-refugee immigrants and native-born Danes, perhaps due to confounding in the latter groups or different place-based experiences by immigration status. Future research is warranted to explain the reasons for contrasting findings.

To test the hypothesis that early-life adversity accelerates the pace of biological aging, we analyzed data from the Dutch Hunger Winter Families Study (DHWFS, N = 951). DHWFS is a natural-experiment birth-cohort study of survivors of in-utero exposure to famine conditions caused by the German occupation of the Western Netherlands in Winter 1944 to 1945, matched controls, and their siblings. We conducted DNA methylation analysis of blood samples collected when the survivors were aged 58 to quantify biological aging using the DunedinPACE, GrimAge, and PhenoAge epigenetic clocks. Famine survivors had faster DunedinPACE, as compared with controls. This effect was strongest among women. Results were similar for GrimAge, although effect-sizes were smaller. We observed no differences in PhenoAge between survivors and controls. Famine effects were not accounted for by blood-cell composition and were similar for individuals exposed early and later in gestation. Findings suggest in-utero undernutrition may accelerate biological aging in later life. [ABSTRACT FROM AUTHOR]

This study aims to investigate the effect of Ramadan intermittent fasting on cognitive work performance using a more natural approach. To achieve the objective of this study, a natural experimental approach was employed by incorporating a pretest-posttest control group design. A forward-type Digit Span Test (DST) was utilized as the measure of the cognitive work performance and was administered to participants twice, before and during Ramadan, with one-month gap between the tests. Two hundred and sixty-seven participants were naturally grouped into fasting and non-fasting groups according to their report during Ramadan session and into morning and afternoon periods, or AM and PM hours, according to their module scheduling. The results of the analyses suggest that the cognitive work performance of the fasting participants during the PM hours is better, after controlling the DST scores before Ramadan. The study also concludes that the cognitive work performance of the fasting participants between AM and PM hours does not differ. This result could be explained using the perspectives of post-lunch performance dip and the beneficial effect of breakfast. Methodological limitations and potential practical implementation of this study are also discussed. [ABSTRACT FROM AUTHOR]

Study Design: Systematic review. Objectives: To determine if the natural experiment design is a useful research methodology concept in spinal trauma care, and to determine if this methodology can be a viable alternative when randomized controlled trials are either infeasible or unethical. Methods: A Medline, Embase and Cochrane database search was performed between 2004 and 2023 for studies comparing different treatment modalities of spinal trauma. All observational studies with a natural experiment design comparing different treatment modalities of spinal trauma were included. Data extraction and quality assessment with the MINORS criteria was performed. Results: Four studies with a natural experiment design regarding patients with traumatic spinal fractures were included. All studies were retrospective, one study collected follow-up data prospectively. Three studies compared different operative treatment modalities, whereas one study compared different antibiotic treatment strategies. Two studies compared preferred treatment modalities between expertise centers, one study between departments (neuro- and orthopedic surgery) and one amongst surgeons. For the included retrospective studies, MINORS scores (maximum score 18) were high ranging from 12-17 and with a mean (SD) of 14.6 (1.63). Conclusions: Since 2004 only four studies using a natural experiment design have been conducted in spinal trauma. In the included studies, comparability of patient groups was high emphasizing the potential of natural experiments in spinal trauma research. Natural experiments design should be considered more frequently in future research in spinal trauma as they may help to address difficult clinical problems when RCT's are infeasible or unethical. [ABSTRACT FROM AUTHOR]

Background: Regulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world's first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils. Methods: With a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status. Results: Longitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings. Conclusions: This regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere. [ABSTRACT FROM AUTHOR]

We study how expectations of fund flows causally affect fund performance by exploiting a quasi-natural experiment in the Australian pension system where an unexpected policy change temporarily allowed fund withdrawals from a prespecified date in the future. Using fractions of young members, middle-aged members, and government co-contributions for low-income earners as instrumental variables, we find an insignificant effect of expected fund outflows on performance. A potential explanation is that Australian superannuation funds preemptively engage in liquidity management in response to changes in expectations of future fund flows and this helps to limit direct and indirect costs in the rebalancing process. JEL Classification: G11, G12, G14, G23, G51 [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of the COVID-19 pandemic associated governmental restrictions on physical activity and sedentary behavior of school-going adolescents in India and its effect on nutrition and health status. Methods: This was a before-after natural experiment study that recorded paired data of 449 (206 boys) school-going adolescents. COVID-19 related governmental measures (March 24, 2020 till February 2021) were taken as the natural experiment. The change in proportion of adolescents who met the recommended amount of physical activity guidelines and change in sedentary and dietary behaviors and body mass index (BMI) were compared. Results: The proportion of adolescents performing adequate physical activity decreased from 33.9% to 30.7% (OR 1.2,95% CI 0.9,1.6) during the pandemic. Fruit intake increased by 8.1% during the pandemic while junk food intake decreased by 17% during the pandemic. Mean (SD) BMI z-scores increased from −0.7)1.4) to −0.5)1.3) (P < 0.001). Conclusion: While there was a small decrease in the proportion of physically active adolescents during the pandemic, a shift towards healthier dietary habits was seen. [ABSTRACT FROM AUTHOR]

Using data on green patents filed at the European Patent Office from 1980 to 1984, this paper investigates the effect of increasing government R&D budget on green technology spillovers. Spillovers are measured with patent forward citations over the period 1981–1988. The level of government R&D budget is instrumented leveraging the unexpected occurrence of the Chernobyl nuclear accident—that exogenously pushed governments to reduce their energy-related R&D budgets—in a difference in differences setting. 2SLS results show that a 10% increase in government R&D increases by some 0.7% the number of citations received by green patents. Although positive and significant, the small magnitude of the estimated elasticity suggests that government R&D takes time to let innovation spillovers from green technologies to materialize with some relevance. Interestingly, increasing government R&D expenditures fosters green technology spillovers across traditional (non-green) fields and enlarges the technological breadth of inventions citing green patents. Overall, I conclude that government R&D fosters green knowledge spillovers, accelerates hybridization processes and favors technological diversification around green technologies. However, these positive effects seem to materialize at a slow pace. [ABSTRACT FROM AUTHOR]

Background Globally alcohol consumption is a leading risk factor for premature death and disability and is associated with crime, social and economic consequences. Local communities may be able to play a role in addressing alcohol-related issues in their area. Objectives To evaluate the effectiveness and cost–benefit of an asset-based community development approach to reducing alcohol-related harm and understand the context and factors that enable or hinder its implementation. Design A mixed-methods evaluation. Area-level quasi-experimental trial analysed using four different evaluation methods (a stepped-wedge design where each area was a control until it entered the intervention, comparison to matched local/national controls and comparison to synthetic controls), alongside process and economic evaluations. Setting Ten local authorities in Greater Manchester, England. Participants The outcomes evaluation was analysed at an area level. Ninety-three lay persons representing nineareas completed questionnaires, with 12 follow-up interviews in five areas; 20 stakeholders representing ten areas were interviewed at baseline, with 17 follow-up interviews in eight areas and 26 members of the public from two areas attended focus groups. Interventions Professionals in a co-ordinator role recruited and supported lay volunteers who were trained to become alcohol health champions. The champion’s role was to provide informal, brief alcohol advice to the local population and take action to strengthen restrictions on alcohol availability. Main outcome measures Numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs, street-level crime and antisocial behaviour in the intervention areas (area size: 1600–5500 residents). Set-up and running costs were collected alongside process evaluation data exploring barriers and facilitators. Data sources Routinely collected quantitative data on outcome measures aggregated at the intervention area and matched control and synthetic control areas. Data from policy documents, licensing registers, meeting notes, invoices, time/cost diaries, training registers, questionnaires, interviews, reflective diaries and focus groups. Results The intervention rolled out in nine out of ten areas, seven of which ran for a full 12 months. Areas with better-established infrastructure at baseline were able to train more champions. In total, 123 alcohol health champions were trained (95 lay volunteers and 28 professionals): lay volunteers self-reported positive impact. Champions engaged in brief advice conversations more readily than taking action on alcohol availability. There were no consistent differences in the health and crime area-level indicators between intervention areas and controls, as confirmed by using three different analysis methods for evaluating natural experiments. The intervention was not found to be cost-beneficial. Limitations Although the sequential roll-out order of the intervention was randomised, the selection of the intervention areas was not. Self-reported impact may have been subject to social desirability bias due to the project’s high profile. Conclusions There was no measurable impact on health and crime outcomes. Possible explanations include too few volunteers trained, volunteers being unwilling to get involved in licensing decisions, or that the intervention has no direct impact on the selected outcomes. Future work Future similar interventions should use a coproduced community outcomes framework. Other natural experiment evaluations should use methodological triangulation to strengthen inferences about effectiveness. Trial registration This trial is registered as ISRCTN81942890. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information. Plain language summary What was the question? Alcohol consumption puts an individual’s health and social relationships at risk of harm. The more a person drinks, the more harmful it is. The harmful effects can place a burden on emergency services and hospitals. We wanted to find out whether community members can make a difference by taking action to address alcohol harm in their local area. What did we do? Local councils in Greater Manchester developed a project called Communities in Charge of Alcohol, where volunteers in targeted local areas were trained to become ‘alcohol health champions’. Alcohol health champions gave alcohol-related brief advice to people to help them drink less. They had a say about when, where and how alcohol is sold by reporting issues to their local council. We compared numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs and reports of crime and antisocial behaviour between areas that had alcohol health champions with other similar areas in England that did not. We calculated how much it costs to run and whether Communities in Charge of Alcohol could save society money. What did we find? Not as many volunteers came forward to become an alcohol health champion as hoped for. Those who did give alcohol-related brief advice to people. They preferred not to report issues about alcohol sales to their local council, either because it was too complicated or because they did not want to be called a ‘grass’. We did not find levels of alcohol harm changed in the Communities in Charge of Alcohol areas. Because of this, we could not demonstrate that Communities in Charge of Alcohol could save society money. What does this mean? Getting involved in alcohol licensing decisions needs to be made easier for communities, with more anonymity, through the support of professionals. More work needs to be done to understand whether giving brief advice can reduce alcohol harm in whole communities. Scientific summary Background The availability of, and access to, alcohol is a key determinant of alcohol harm, and powers exist within the Licensing Act 2003 of England and Wales that enable the public to influence the local sale and supply of alcohol. At an individual level, implementing programmes to promote early risk identification and brief advice have the potential to reduce alcohol consumption and prevent alcohol-related harm, but there is a dearth of evidence to determine the feasibility and effectiveness of lay people having a role. The Greater Manchester (GM) Combined Authority (GMCA) and Greater Manchester Health and Social Care Partnership (GMHSCP) designed a new programme, ‘Communities in Charge of Alcohol’ (CICA) in 2017 to train lay volunteers to become alcohol health champions (AHCs), who would be able to (1) give alcohol-related brief advice to individuals and (2) help communities influence alcohol availability and strengthen restrictions in alcohol risk environments. Overall aims To evaluate the effectiveness and cost–benefit of implementing a locally delivered AHC intervention and understand the context and factors that enable or hinder the intervention. Objectives Relating to the outcome evaluation: to determine the effect on area-level key health performance indicators: alcohol-related hospital admissions (narrow measure), weekend accident and emergency (A&E) attendances (Friday 3 p.m.–Sunday 3 p.m.), weekday A&E attendances (Monday–Friday 9 a.m.–5 p.m. each day), weekend ambulance call-outs (Friday 3 p.m.–Sunday 3 p.m.), weekday ambulance call-outs (Monday–Friday 9 a.m.–5 p.m. each day) to determine the effect on key crime indicators (street-level crime data) at the weekend (Friday 3 p.m.–Sunday 3 p.m.) and weekday (Monday–Friday 9 a.m.–5 p.m. each day) to determine the effect on key antisocial behaviour (ASB) indicators (police recorded calls for service were classified as ASB according to the National Standard for Incident Recording). Relating to the process evaluation: to explore policy context and variation in licensing practice, including any impact of devolution in GM to explore barriers and facilitators at key stages of the implementation of the intervention: recruitment of AHCs to initial training and cascade training, delivery of initial training and cascade training, use of skills beyond the training in AHC activity, retention of AHCs to explore responses to AHC training, modelling of health behaviours, perceptions of community cohesion and development to determine numbers of brief interventions applied and community awareness events organised/participated in to examine and quantify the amount and success of community involvement in licensing issues to determine whether there was a change in composite measures of alcohol availability. Relating to the economic evaluation: to identify set-up and running costs using a standardised costing exercise to resolve costs by sector (health, ambulance and police) before, during and after set-up to quantify benefits due to reduced hospital admissions, ambulance call-outs, A&E use, crime and ASB. Methods Communities in Charge of Alcohol was a complex intervention already planned by the GMCA in 10 small local authority areas (~1600–5500 residents each) and was outside direct researcher control. Intervention areas were chosen by each local authority public health team as having high levels of alcohol harm in comparison to the rest of the local authority. All intervention areas were at the bottom of the deprivation index, in deprivation decile 1 or 2. Using a stepped-wedge design, researchers were able to randomise the order of roll-out of intervention areas to bring a quasi-experimental approach to the evaluation. Two additional evaluation designs were used in order to triangulate findings, namely comparison to matched controls and comparison to synthetic controls. Ethical approval was received from the University of Salford Research Ethics Committee on 17 May 2017 (reference number: HSR1617–135) and obtained from the University of Bristol on 16 May 2019 (reference number: 82762). Outcome evaluation data sources Routinely collected data at the lower-layer super output area (LSOA) level for intervention areas was compared with control areas. Data sources were as follows: alcohol-related hospital admissions data – Public Health England (now Office for Health Improvement and Disparities) accident and emergency department attendance data – NHS Digital ambulance call-out data – North West Ambulance Service reported crime and ASB data – GM Police. Analysis spanned a 10-year period (7 years pre intervention and a maximum of 3 years post implementation), ending in January 2020. Data were analysed using log-rate growth models and time series analyses to quantify the effect of the CICA programme on key performance indicators. Process evaluation data sources Pre-implementation phase document review of local Statements of Licensing Policy (n = 9), alcohol availability composite score of on- and off-licensed premises (n = 9 areas), roll-out preparatory meeting notes. Train-the-Trainer attendance registers by area (n = 5, representing 9 areas, attended by 48 lay participants and 25 professional participants). Cascade training attendance registers by area (n = 11, representing 7 areas, attended by 47 lay participants and 3 professional participants). Pre- and post-training questionnaires (n = 93 lay people, 98% response rate). Baseline interviews with stakeholders (n = 20) (initial implementation phase); interviews with lay volunteer AHCs (n = 5, representing 3 areas) within 3–6 months of initial training (implementation phase). Follow-up interviews (12 months) with stakeholders (n = 11, representing eight areas), licensing officers (n = 6, representing six areas) and lay volunteer AHCs (n = 7, representing four areas); follow-up questionnaires with AHCs (n = 11); focus groups with local residents (n = 3 groups, representing two areas, with a total of 26 participants). Economic evaluation data sources Time and transportation costs incurred during project meetings aggregated from meeting minutes and stakeholder time/cost diaries. Invoices for the design, development and delivery of training packages and accreditation fees. Invoices for the qualification and assessment fees, time and miscellaneous (transportation, room hire, catering, printing costs). AHC time and costs aggregated from volunteer diaries and stakeholder time/cost diaries. Invoices for engagement materials (AUDIT-C scratchcards). Greater Manchester Combined Authority research team’s (formerly New Economy) cost–benefit analysis (CBA) tool was populated using aggregated outcome evaluation data to resolve costs for each key performance indicator before, during and after CICA setup. Results Nine out of 10 local authorities rolled out the CICA intervention on their given start date: seven areas completed a full year, carrying out cascade training in the first 12 months, two areas withdrew at 6 and 9 months and one area withdrew in the pre-implementation phase. There were 118 [interquartile range (IQR): 60–205] alcohol-related hospital admissions per month per pre-intervention LSOA, rising to 134 (IQR: 67–203) post intervention. Some outcomes had very small counts at the LSOA level; notably, there were only 2 (IQR: 1–3) weekend crimes per month pre-intervention and 4 (IQR: 2–6) post intervention. The primary, stepped-wedge analyses provide weak evidence of an average increase in alcohol-related hospital admissions following the implementation of CICA of about 13%, corresponding to about 20 admissions weekly, although the confidence interval was wide, −1.98 to 31.39, and not statistically significant (p~0.09), while the analysis that made use of local controls suggested a bigger effect, at 16.4% (7.33–26.16, p

Abstract Live oyster reefs are considered a critical recruitment habitat for estuarine faunal populations as localized in situ or mesocosm studies have demonstrated many faunal species prefer live oyster habitat. It has therefore been assumed that the loss of live oyster habitat would precipitate faunal population declines, but this has been largely untested at large (estuary) scales. Here, we assessed how estuary‐wide faunal populations were affected by a 95% loss of live oyster habitat following the 2012 oyster collapse of Apalachicola Bay, FL, which previously supported one of the largest oyster fisheries in the United States. We standardized long‐term fisheries‐independent monitoring seine and trawl data to create relative indices of resident, associated, and transient faunal species' overall abundance and recruit abundance (restrictive to sizes between 15% and 35% of L∞). We expected that both relative abundance indices would decrease following the oyster collapse, particularly among species that reside on or recruit to oyster reefs. However, analyses via a series of one‐sided Bayesian t tests did not indicate that faunal recruitment or overall abundance significantly declined in 2012 post‐collapse. As the response of the faunal population could be lagged relative to the 2012 collapse, we also conducted change point analyses to search for lagged declines. Of the 24 relative abundance time series, only two had significant change points post‐collapse, and only black sea bass overall relative abundance declined with an associated change point at the end of the time series. The surprising paucity of faunal decline following oyster loss may be due to the use of alternative habitat types, exceptionally lagged faunal responses, or, perhaps most compelling, a disconnect between preferred and required habitats. Our failure to detect faunal consequences following an oyster population collapse suggests that assumptions of habitat loss (or restoration) effects on estuarine fauna at ecosystem scales are not straightforward and the extrapolation of sub‐estuary‐scale studies may result in poor predictions of future outcomes.

Abstract Background Evidence on the association between fast-food outlet exposure and Body Mass Index (BMI) remains inconsistent and is primarily based on cross-sectional studies. We investigated the associations between changes in fast-food outlet exposure and BMI changes, and to what extent these associations are moderated by age and fast-food outlet exposure at baseline. Methods We used 4-year longitudinal data of the Lifelines adult cohort (N = 92,211). Participant residential addresses at baseline and follow-up were linked to a register containing fast-food outlet locations using geocoding. Change in fast-food outlet exposure was defined as the number of fast-food outlets within 1 km of the residential address at follow-up minus the number of fast-food outlets within 1 km of the residential address at baseline. BMI was calculated based on objectively measured weight and height. Fixed effects analyses were performed adjusting for changes in covariates and potential confounders. Exposure-moderator interactions were tested and stratified analyses were performed if p

Educational systems that separate students into curriculum tracks later may place less emphasis on socioeconomic family background and allow individuals' personal skills and interests more time to manifest. We tested whether postponing tracking from age 11 to 16 results in stronger genetic prediction of education across a population, exploiting the natural experiment of the Finnish comprehensive school reform between 1972 and 1977. The association between polygenic score of education and achieved education strengthened after the reform by one-third among men and those from low-educated families. We observed no evidence for reform effect among women or those from high-educated families. The first cohort experiencing the new system had the strongest increases. From the perspective of genetic prediction, the school reform promoted equality of opportunity and optimal allocation of human capital. The results also suggest that turbulent circumstances, including puberty or ongoing restructuring of institutional practices, may strengthen genetic associations in education.

Abstract Teachers in Japanese schools employ alphabetical surname lists that call students sooner, with surnames appearing early on these lists. We conducted Internet surveys nearly every month from March 2020 to September 2022 with the same participants, wherein we asked participants where the alphabetical columns of their childhood and adult surnames were located. We aimed to identify how surname order is important for the formation of noncognitive skills. During the data collection period, the COVID-19 vaccines became available; Japanese people could receive their third dose starting in December 2021. The 19th wave of the survey was conducted in January 2022. Therefore, to examine how a surname’s alphabetical order could influence intention to revaccinate, we used a subsample of data from December 2021 to September 2022. The major findings were as follows. Women with early surnames had an approximately 4% stronger likelihood of having such intentions than men with early surnames. Early name order was more strongly correlated with revaccination intention among women than among men. The surname effect for women was larger when a mixed-gender list was used compared with when it was not used. This effect was only observed for childhood surnames and not for adult surnames.

A narrative in ecology is that prey modify traits to reduce predation risk, and the trait modification has costs large enough to cause ensuing demographic, trophic and ecosystem consequences, with implications for conservation, management and agriculture. But ecology has a long history of emphasising that quantifying the importance of an ecological process ultimately requires evidence linking a process to unmanipulated field patterns. We suspected that such process-linked-to-pattern (PLP) studies were poorly represented in the predation risk literature, which conflicts with the confidence often given to the importance of risk effects. We reviewed 29 years of the ecological literature which revealed that there are well over 4000 articles on risk effects. Of those, 349 studies examined risk effects on prey fitness measures or abundance (i.e., non-consumptive effects) of which only 26 were PLP studies, while 275 studies examined effects on other interacting species (i.e., trait-mediated indirect effects) of which only 35 were PLP studies. PLP studies were narrowly focused taxonomically and included only three that examined unmanipulated patterns of prey abundance. Before concluding a widespread and influential role of predation-risk effects, more attention must be given to linking the process of risk effects to unmanipulated patterns observed across diverse ecosystems.

This paper shows that the entry of a for-sale-by-owner platform reduces the intermediation pricing. Intermediary agents play a crucial role in connecting sellers and buyers across various markets. However, the emergence of digital platforms has provided more affordable channels for direct transactions, challenging the dominance of agents. In this study, we examine the impact of a for-sale-by-owner (FSBO) platform on real estate agents' listing prices. By using a natural experiment in China, we find that the introduction of the FSBO platform leads to a 2.8% decrease in listing prices, a percentage comparable to the commission rate typically charged by agents. The cost advantage provided by the FSBO platform appears to be the primary driver behind this price drop rather than selection bias in listings. Furthermore, the impact of reduced listing prices extends to the final sales price of the properties. These findings carry important policy implications for competition regulation of intermediaries. History: Catherine Tucker served as the senior editor. Funding: This work was supported by the startup grant at the Hong Kong Polytechnic University [1-BE6Y]. Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mksc.2022.0245. [ABSTRACT FROM AUTHOR]

This paper provides evidence from a natural experiment on the relationship between positive affect and productivity. We link highly detailed administrative data on the behaviors and performance of all telesales workers at a large telecommunications company with survey reports of employee happiness that we collected on a weekly basis. We use variation in worker mood arising from visual exposure to weather—the interaction between call center architecture and outdoor weather conditions—to provide a quasi-experimental test of the effect of happiness on productivity. We find evidence of a positive impact on sales performance, which is driven by changes in labor productivity—largely through workers converting more calls into sales and to a lesser extent by making more calls per hour and adhering more closely to their schedule. We find no evidence in our setting of effects on measures of high-frequency labor supply such as attendance and break-taking. This paper was accepted by Yuval Rottenstreich, behavioral economics and decision analysis. Supplemental Material: The data files and online appendices are available at https://doi.org/10.1287/mnsc.2023.4766. [ABSTRACT FROM AUTHOR]

A method has been proposed that allows calculating the parameters of a vortex cooling system for aircraft equipment as functions of flying conditions. The optimum configuration and the dimensions of basic elements of the vortex tube have been determined. By the numerical-modeling method, the operating parameters of the vortex system have been obtained. The adequacy of a computational model has been checked. [ABSTRACT FROM AUTHOR]

Why might start-ups not change even when doing so may enhance firm performance? It seems reasonable to point to founder presence as a potential culprit given founders' cognitive myopia and/or commitment to the status quo. However, founder presence may instead be a facilitator of change in response to environmental uncertainty because founders can uniquely coordinate resources needed for organizational change. We empirically address these two opposing views on the impact of founder presence (versus loss) on organizational change by using a comprehensive administrative data set of start-ups in the United States. Correlational analysis shows that start-ups generally become less likely to change following founder turnover. Given the potentially endogenous nature of founder turnover, we exploit premature deaths as a natural experiment that suddenly removes some founders from their start-ups while leaving others intact. We find that start-ups are less likely to change after losing a founder, especially if the founder loss happens during an economic recession. At the same time, the effect is attenuated when losing a founder with more experience in the same industry, suggesting that founder presence can also contribute to reinforcing the status quo under some conditions. Broadly, these results not only show that founders tend to facilitate change in their organizations but also identify when founders are merely subject to organizations' bureaucratic forces that they themselves may have imprinted originally. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2023.1668. [ABSTRACT FROM AUTHOR]

This study aims to investigate the effect of Ramadan intermittent fasting on cognitive work performance using a more natural approach. To achieve the objective of this study, a natural experimental approach was employed by incorporating a pretest-posttest control group design. A forward-type Digit Span Test (DST) was utilized as the measure of the cognitive work performance and was administered to participants twice, before and during Ramadan, with one-month gap between the tests. Two hundred and sixty-seven participants were naturally grouped into fasting and non-fasting groups according to their report during Ramadan session and into morning and afternoon periods, or AM and PM hours, according to their module scheduling. The results of the analyses suggest that the cognitive work performance of the fasting participants during the PM hours is better, after controlling the DST scores before Ramadan. The study also concludes that the cognitive work performance of the fasting participants between AM and PM hours does not differ. This result could be explained using the perspectives of post-lunch performance dip and the beneficial effect of breakfast. Methodological limitations and potential practical implementation of this study are also discussed.

Introduction: This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents. Methods: This retrospective cohort study utilized electronic health records of individuals aged 5–18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers. Linear mixed-effects models performed in 2022 tested whether built environment variables at baseline were associated with BMI change within age cohorts (5, 9, and 13 years), adjusting for sex, age, race/ethnicity, Medicaid, BMI, and residential property values (SES measure). Results: At 3-year follow-up, higher residential density was associated with lower BMI increase for girls across all age cohorts and for boys in age cohorts of 5 and 13 years but not for the age cohort of 9 years. Presence of fast food was associated with higher BMI increase for boys in the age cohort of 5 years and for girls in the age cohort of 9 years. There were no significant associations between BMI change and counts of parks, and park area was only significantly associated with BMI change among boys in the age cohort of 5 years. Conclusions: Higher residential density was associated with lower BMI increase in children and adolescents. The effect was small but may accumulate over the life course. Built environment factors have limited independent impact on 3-year BMI trajectories in children and adolescents.

There is little robust evidence of how sustainable park interventions impact on physical activity and other behaviours important for wellbeing. This controlled natural experimental study aimed to examine the effects of co-designing a sustainable park intervention, in a deprived UK urban area, on walking and other wellbeing behaviours.Behaviour observations were conducted at two intervention sites and two matched comparison sites (n = 4,783). Walking observations (primary outcome), wellbeing behaviours (vigorous, sedentary, social and take notice activities) and demographic characteristics were assessed at pre-intervention, and post-intervention (3 and 15 months). Outcomes were compared between intervention and comparison groups, controlling for pre-intervention using multilevel negative binomial regression models. Additional behaviour observations were conducted in two unchanged nearby sites to assess changes in general local activity. Intercept surveys (n = 623) assessed change in self-reported outdoor space usage at intervention and control areas.Post-intervention, walking increased 203 % at 3 months (IRR 2·03, 95 % CI 1·01-4·09) and 351 % at 15 months (IRR 3·51, 95 % CI 2·07-5·93), for intervention sites relative to comparison sites. Large increases for other wellbeing behaviours were also observed. The proportion of non-white persons increased substantially post-intervention, compared to comparison sites. Nearby unchanged sites showed little evidence of general increased activity. Self-reported outdoor usage increased more in the intervention sites (p=

Extreme weather events are predicted to increase as a result of climate change, yet amphibian responses to extreme disturbance events remain understudied, especially in the Neotropics. Recently, an unprecedented windstorm within a protected Costa Rican rainforest opened large light gaps in sites where we have studied behavioral responses of diurnal strawberry poison frogs (Oophaga pumilio) to ultraviolet radiation for nearly two decades. Previous studies demonstrate that O. pumilio selects and defends perches where ultraviolet radiation (UV-B) is relatively low, likely because of the lethal and sublethal effects of UV-B. In this natural experiment, we quantified disturbance to O. pumilio habitat, surveyed for the presence of O. pumilio in both high-disturbance and low-disturbance areas of the forest, and assessed UV-B levels and perch selection behavior in both disturbance levels. Fewer frogs were detected in high-disturbance habitat than in low-disturbance habitat. In general, frogs were found vocalizing at perches in both disturbance levels, and in both cases, in significantly lower UV-B levels relative to ambient adjacent surroundings. However, frogs at perches in high-disturbance areas were exposed to UV-B levels nearly 10 times greater than males at perches in low-disturbance areas. Thus, behavioral avoidance of UV-B may not reduce the risks associated with elevated exposure under these novel conditions, and similarly, if future climate and human-driven land-use change lead to sustained analogous environments.