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No full textThis book has aimed to reframe technologies—and the prevailing myths around them—by displacing hegemonic language. Our motivation for doing so has been twofold: to better understand the incursions of technologies into our lives and, importantly, to make visible the ways in which technologies subjugate minoritised groups. We propose that renaming technologies is one way for people in dominant groups to do the work of allyship: to prompt reflection on our own complicity with harm-marking symbols and, ultimately, to participate in discursive practices that can bring emancipatory relations into being. Rather than continue to think of ourselves as technology ‘users’, we invoke the term ‘operative’, signalling resistance to the language and practices of Big Tech while thinking towards a reclaiming of agency
Re-estimation of Medicare spending for semaglutide after most favored nation and Medicare drug price negotiation announcements
No full textIn late 2025, the White House announced new Most Favored Nation (MFN) pricing agreements for the glucagon-like peptide-1 receptor agonist class, including 3 semaglutide products, establishing substantially lower prices for Medicare and Medicaid. Shortly after, the Centers for Medicare and Medicaid Services released Maximum Fair Prices (MFPs) for selected drugs under IPAY 2027, revealing semaglutide prices that differed from the MFN prices and from earlier assumptions used in prior economic evaluations, including our prior article. Using previously published forecasting methods, we updated our 10-year (2026-2035) Medicare spending estimates for semaglutide across all US Food and Drug Administration (FDA)-approved indications under both the newly announced MFP and MFN price structures. Incorporating revised 30-day MFPs for Ozempic, Rybelsus, and Wegovy, as well as patient cost-sharing assumptions and future generic entry, we now estimate Medicare savings of 328 to 1.78 billion with loss-of-exclusivity assumptions. Using the lower MFN price of 600 annual patient copay, estimated Medicare savings increase substantially to 1.03 to 2.63 billion with generic entry. These findings highlight the significant fiscal impact of recent price negotiations and underscore uncertainties regarding the durability and future scope of MFN-based drug pricing arrangements
Tribal politics: how Brexit divided Britain
No full textThe Brexit referendum was a pivotal moment in British politics. Tribal Politics argues this is not only because it led to the UK's departure from the European Union, but because it created two new, powerful, and enduring political identities in the UK: Leavers and Remainers. These new identities rapidly became central to how people saw themselves, others, and the world around them, and they continue to underpin British politics. Tribal Politics explores how these identities emerged and why they have proved so resilient in the years since the 2016 vote. It does so by considering the Brexit divide as the result of three contingent factors: issue contestation (intense, high-stakes public conflict), issue expression (individual commitment through voting and political engagement), and issue alignment (the way Brexit cut across traditional party lines). This context transformed a policy question to which most people were largely indifferent into a deep-seated identity divide. Drawing on political psychology and a wide range of original evidence - including surveys, experiments, and analysis of political discourse - Sara B. Hobolt and James Tilley examine the far-reaching consequences of tribal politics for political attitudes and choices. They consider the impact on how we respond to and treat those in another tribe as well as on the way our views of reality, our policy opinions, and even our perceptions of democratic legitimacy to fit our tribal loyalties. While grounded in the Brexit experience, Tribal Politics speaks to the origins, and consequences, of all types of identity-driven affective polarization. As many democracies around the world confront deepening political divides, it offers timely insights into how one political moment can spark lasting tribalism and why those tribes so often survive long after that moment has passed
The impact of COVID-19 on general vaccine acceptance in low- and middle-income countries: a systematic review
Full text linkBackground The COVID-19 pandemic caused a major decline in childhood vaccination, especially in low- and middle-income countries (LMICs). However, its specific impact on vaccine hesitancy in the immediate post-pandemic years, particularly toward non-COVID-19 vaccines, remains unclear. Understanding the social and behavioral factors influencing vaccine acceptance following a public health emergency such as the COVID-19 pandemic is critical to improving immunization coverage. This systematic review examined the impact of the COVID-19 pandemic on general vaccine acceptance in LMICs to inform strategies to improve vaccine uptake. Methods This systematic review assessed people's thinking and feeling, motivations, practical issues, and social processes around vaccination, conceptualized by the World Health Organization's Behavioural and Social Drivers framework. Studies were included if they were interventional or observational in design, examined the impact of the COVID-19 pandemic on vaccine hesitancy or acceptance for non-COVID-19 vaccines, and were published in English between 2020 and 2023. Results A total of 23 studies were included in the review, with most studies conducted in middle-income settings and focused on healthcare workers or parents/caregivers of children. Findings belonging to the “Thinking and Feeling” category were the most commonly reported in 91% ( n = 21/23) of studies. Over half (61%) of studies reported findings relating to the ‘Motivation' construct, while 43% of studies reported outcomes related to ‘Practical Issues' and ‘Social Processes'. Studies reported both increases and decreases in vaccine hesitancy and intention to vaccinate due to the pandemic. Overall, studies most commonly reported that the COVID-19 pandemic had a negative or neutral effect on attitudes, intentions, and actions regarding vaccine acceptance. Conclusion This systematic review illustrates how the COVID-19 pandemic influenced vaccine acceptance and decision-making in complex, context-dependent ways, impacting people's thinking and feeling, motivations, practical issues, and social processes around vaccination. The findings highlight the need to understand the specific drivers of vaccine acceptance to design more effective, targeted strategies to improve immunization uptake. The insights from this study can be used to inform evidence-based vaccination catch-up strategies to regain pandemic losses and mitigate factors that deter individuals from seeking vaccination
Dependency or subsidization? An input-output analysis of the interconnectedness of regional growth models in Italy
Full text linkThis article demonstrates the applicability of the growth model framework at the regional level. Focusing on Italy as a paradigmatic case of persistent regional inequalities, we test two theories of center-periphery relations between Northern and Southern Italy: the dependency theory and the subsidization theory. Using EUREGIO regional input-output tables between 2000 and 2007, we decompose the GDP and GDP growth of Italian regions into final demand components and economic sectors. The results highlight the importance of distinguishing between static and dynamic analyses. The former reveal a greater reliance of the economy of the Southern regions on the public sector, corroborating the subsidization perspective. By contrast, the latter indicate that in 2000–2007 Southern Italy’s GDP growth was driven by low value-added exports to Northern regions, buttressing the Gramscian dependency argument. We link changes in regional growth models to the impact of EU fiscal policy rules
Why do we disagree about sustainable finance?
No full textSustainable finance has long been the subject of considerable disagreement. This chapter seeks to shed light on these disagreements by focusing on (a) what people disagree about, (b) why they disagree and (c) how best to address disagreements. Rather than treating disagreement as a flaw to be fixed, the authors suggest that it may be inherent to sustainable finance, reflecting the concept’s appraisive, internally complex and open-ended character. The authors identify three attributes that underpin disagreements in sustainable finance: values concerning what people consider important or desirable; beliefs about sustainability and appropriate responses; and interests representing the outcomes different actors seek to achieve. The chapter invites readers to adopt a more reflexive approach, asking questions of themselves and others when engaging in debates and controversies. A core argument is that a better understanding of why people disagree places us in a stronger position to move beyond entrenched positions and to identify common ground and collective expectations for sustainable finance
Transforming long-term care: a participatory theory of change approach toward community-centered solutions
No full textLong-term care is a priority for public policy in Spain, especially after COVID-19. The InCARE Project (Supporting INclusive development of community-based long-term CARE services through multi-stakeholder participatory approaches) promoted participatory policy and service development, using a Theory of Change (ToC) approach. The Theory of Change describes a causal pathway for making strategic changes in the long-term care system over the next decade, aiming to achieve the desired impacts. A two-day workshop was held with 32 stakeholders, including policymakers, professionals, family carers, and people who use care services. A national ToC and a specific pilot project ToC outlined the steps required to improve the long-term care system to fulfill the needs and preferences of people in situations of dependency. The Theory of Change approach can be highly valuable for policy design, and it provides an integrated action map to guide the changes and inform political and management actions in the coming years
From the green to the just transition: the emergence of the compensatory state in the EU's approach to climate change
No full textIn this paper, we investigate the adaptation of the EU climate stances between the early 2000s until today. Historically tracing the EU's approach to the green transition, we highlight an increasing role of interventionist frames within European discourses and policies. As the realms of intervention have increased, so has the EU's emphasis on the need to provide social protection for the sections of the population that have more to lose from a large‐scale transition. We understand this process as signalling the increasing relevance of what we call the Compensatory State. This concept points to a form of governance that, by setting itself ambitious goals that (if implemented) would have widespread effects on large portions of the population, needs to produce equally extended forms of compensations. The paper historically traces the development of this form of governance from the previously prevalent frameworks (which we understand through the concepts of the Regulatory State and the Competitiveness‐enhancing State). The paper integrates contemporary attempts to theorise the role of public authorities within the EU's green transition. In addition, our analysis challenges the expectations of the extant literature in political economy, which looks at increasing social protection mainly as a public solution to market distortions
Nonparametric causal inference with functional covariates
No full textFunctional data and their analysis have become increasingly popular in various fields of data science. This article considers estimation and inference of the average treatment effect under unconfoundedness when the covariates involve a functional variable, and proposes the inverse probability weighting estimator, where the propensity score is estimated by using a kernel estimator for functional variables. We establish the √-consistency and asymptotic normality of the proposed estimator. Numerical experiments and an empirical application demonstrate the usefulness of the proposed method
Psychosocial problems, daily functioning, and help-seeking behaviour of international migrant workers in the Netherlands: a qualitative study to inform the adaptation of a scalable stepped-care intervention
Full text linkInternational migrant workers (IMWs) may face insecure work and housing, limited access to healthcare and increased risk of psychological problems. Two scalable, evidence-based interventions to support individuals experiencing psychological distress are Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). This study aimed to explore IMWs’ problems, daily functioning and help-seeking behaviour, to inform cultural adaptation of the DWM/PM+ stepped-care intervention in the Netherlands. Following the Design, Implementation, Monitoring, and Evaluation (DIME) model, we conducted various qualitative interviews and a focus group discussion with IMWs (n = 30) and professionals (n = 18). Data were analysed thematically, and findings informed adaptations. Participants described problems related to work, housing, administration, finances, healthcare access and the COVID-19 pandemic. Daily routines focused on practical needs. Help-seeking was hindered by stigma, fear of job loss, low trust and reliance on informal or cross-border healthcare. Based on these results, the intervention was adapted to the needs of Polish IMWs in the Netherlands, regarding content and examples, which were tailored to their context; the intervention was offered remotely and collaboration with employers was avoided. These findings highlight the structural vulnerabilities of IMWs and demonstrate how qualitative insights can guide the cultural adaptation of a psychological intervention