Country Case Studies Research Articles

Workplace Violence in Orthopaedic Surgery: A Survey of Academy of Orthopaedic Surgeons Membership.

Workplace violence (WPV) in US health care is increasing, and many workers are likely to experience WPV during their careers. This study aims to assess the scope of WPV in orthopaedics. A 20-item survey adopted from the World Health Organization's 'Workplace Violence in the Health Sector Country Case Studies Research Instruments Survey Questionnaire' was sent to Academy of Orthopaedic Surgeons members, including residents and fellows. Deidentified responses were collected electronically over a 1-month period and assessed. Overall, 1,125 Academy of Orthopaedic Surgeons members participated (5% response rate). Most respondents were male (86%) and identified with the majority ethnic group (80%). WPV of any type was reported by 77.1%. Verbal abuse was the most common type (71.6%), and patients were the most common perpetrators. WPV was most prevalent among traumatologists, tumor surgeons, female surgeons, and those with 0 to 15 years in practice. Female surgeons reported more WPV events per practice year (2.25 versus 0.65, P < 0.01) and increased likelihood of physical threats and physical assaults from coworkers ( P = 0.004). WPV in orthopaedic surgery is largely perpetrated by patients and directed toward traumatologists, tumor surgeons, female surgeons, and less experienced surgeons. These data can be used to address safety measures in the workplace.

Inverting the deficit model in global mental health: An examination of strengths and assets of community mental health care in Ghana, India, Occupied Palestinian territories, and South Africa.

Global mental health [GMH] scholarship and practice has typically focused on the unmet needs and barriers to mental health in communities, developing biomedical and psychosocial interventions for integration into formal health care platforms in response. In this article, we analyse four diverse settings to disrupt the emphasises on health system weaknesses, treatment gaps and barriers which can perpetuate harmful hierarchies and colonial and medical assumptions, or a 'deficit model'. We draw on the experiential knowledge of community mental health practitioners and researchers working in Ghana, India, the Occupied Palestinian Territory and South Africa to describe key assets existing in 'informal' community mental health care systems and how these are shaped by socio-political contexts. These qualitative case studies emerged from an online mutual learning process convened between 39 academic and community-based collaborators working in 24 countries who interrogated key tenets to inform a social paradigm for global mental health. Bringing together diverse expertise gained from professional practice and research, our sub-group explored the role of Community Mental Health Systems in GMH through comparative country case studies describing the features of community care beyond the health and social care system. We found that the socio-political health determinants of global economic structures in all four countries exert significant influence on local community health systems. We identified that key assets across sites included: family and community care, and support from non-profit organisations and religious and faith-based organisations. Strengthening community assets may promote reciprocal relationships between the formal and informal sectors, providing resources for support and training for communities while communities collaborate in the design and delivery of interventions rooted in localised expertise. This paper highlights the value of informal care, the unique social structures of each local context, and resources within local communities as key existing assets for mental health.

Embedded implementation research in programming at scale - the new normal to be!

If you want to run faster, don't just buy a new pair of shoes; also consider your training methods and where you run.This supplement examines six countries that have run faster than others in reducing under-five mortality, taking an implementation research approach, with country case studies done with local researchers and local institutions. Key generalizable learnings are to choose and adapt implementation strategies to context, design strategies to target the most vulnerable, systematically learn from implementation experience, and to leverage non-health-sector contributions.Embedding implementation research in programming has the potential to greatly improve and accelerate the contextualization and implementation of evidence-based child survival interventions to improve equity in coverage and overall effectiveness in reducing under-five mortality. It is now time to build such capacity in local institutions at scale, and incentives for concerned stakeholders to make this the new normal. Regional institutions should now take the lead in making this happen, not just in individual institutions and countries, but across entire regions, supported by global partners.Trial registrationN/A.

Machine learning of public sentiments towards wind energy in Norway

AbstractAcross Europe, negative public opinion has and may continue to limit the deployment of renewable energy infrastructure required for the transition to net‐zero energy systems. Understanding public sentiment and its spatio‐temporal variations is as such important for decision‐making and for developing socially accepted energy systems. In this study, we apply a sentiment classification model based on a machine learning framework for natural language processing, NorBERT, on data collected from Twitter between 2006 and 2022 to analyse the case of wind power opposition in Norway. From the 68,828 tweets with geospatial information, we show how discussions about wind power intensified in 2018/2019 together with a trend of more negative tweets up until 2020, both on a regional level and for Norway as a whole. Furthermore, we find weak geographical clustering in our data, indicating that discussions are country wide and not dominated by specific regional events or developments. Twitter data allow for detailed insight into the temporal nature of public sentiments and extending this research to additional case studies of technologies, countries and sources of data (e.g. newspapers, other social media) may prove important to complement traditional survey research and the understanding of public sentiment.

Cross-country analysis of contextual factors and implementation strategies in under-5 mortality reduction in six low- and middle-income countries 2000-2015.

The Exemplars in Under-5 Mortality (U5M) was a multiple cases study of how six low- and middle-income countries (LMICs), Bangladesh, Ethiopia, Nepal, Peru, Rwanda, and Senegal, implemented health system-delivered evidence-based interventions (EBIs) to reduce U5M between 2000 and 2015 more effectively than others in their regions or with similar economic growth. Using implementation research, we conducted a cross-country analysis to compare decision-making pathways for how these countries chose, implemented, and adapted strategies for health system-delivered EBIs that mitigated or leveraged contextual factors to improve implementation outcomes in reducing amenable U5M. The cross-country analysis was based on the hybrid mixed methods implementation research framework used to inform the country case studies. The framework included a common pathway of Exploration, Preparation, Implementation, Adaptation, andSustainment (EPIAS). From the existing case studies, we extracted contextual factors which were barriers, facilitators, or determinants of strategic decisions; strategies to implement EBIs; and implementation outcomes including acceptability and coverage. We identified common factors and strategies shared by countries, and individual approaches used by countries reflecting differences in contextual factors and goals. We found the six countries implemented many of the same EBIs, often using similar strategies with adaptations to local context and disease burden. Common implementation strategies included use of data by decision-makers to identify problems and prioritize EBIs, determine implementation strategies and their adaptation, and measure outcomes; leveraging existing primary healthcare systems; and community and stakeholder engagement. We also found common facilitators included culture of donor and partner coordination and culture and capacity of data use, while common barriers included geography and culture and beliefs. We found evidence for achieving implementation outcomes in many countries and EBIs including acceptability, coverage, equity, and sustainability. We found all six countries used a common pathway to implementation with a number of strategies common across EBIs and countries which contributed to progress, either despite contextual barriers or by leveraging facilitators. The transferable knowledge from this cross-country study can be used by other countries to more effectively implement EBIs known to reduce amenable U5M and contribute to strengthening health system delivery now and in the future.

Contemporary Forms of Financing for Small and Medium-sized Enterprise: Country Case Study of Croatia

The paper analyzes the financing of small and medium enterprises (SMEs) in the Republic of Croatia. The fundamental goal of the paper is to determine the most common forms of funding sources used by entrepreneurs classified as SMEs, as well as the advantages and disadvantages that each financing model brings. The article pays special attention to financing methods that are less known to the average Croatian entrepreneur, such as peer-to-peer lending, initial coin offering, and security token offering. Unlike the banking system, which serves as an indirect financial system, modern forms of financing allow SMEs to raise funds directly from borrowers. To obtain the most relevant information from practice, the article presents the results of conducted research on financing models for SMEs in Croatia, with a particular focus on the awareness of entrepreneurs about new and contemporary forms of financing. Research was carried out in the form of a survey questionnaire created using Google Forms. The sample for the research consisted of 145 SMEs companies, selected to represent the population from various sectors of activity according to the national categorization of activities, from which 14.48% responded to the survey questionnaire. Research showed a higher rate of awerenes and the utilization of traditional forms of financing compared to modern ones. However, it also indicates a certain readiness to embrace the latter. Although the share of modern forms of financing remains small, research revealed that they constitute an appropriate alternative to traditional banking systems, both as a relatively solid investment channel and as a way to obtain loans with convenient terms.

Multisectoral action to address noncommunicable diseases: lessons from three country case studies.

Multisectoral action is a central component of the global response to the rising prevalence of non-communicable diseases (NCDs). In this paper we aimed to unpack the definition of multisectoral action and provide an overview of the historical context, challenges, and recommendations alongside three country case studies: salt reduction in the UK, tobacco legislation in Nigeria, and regulation of edible oils in Iran. We used an iterative review process to select three country case studies from a list of 20 potential cases previously identified by WHO. At our third round of review we unanimously agreed to focus on salt reduction in the UK, tobacco regulation in Nigeria, and edible oil regulation in Iran as these represented rich cases on diverse risk factors from three different world regions that we felt offered important lessons. We conducted literature reviews to identify further data for each case study. Across the three studies a number of important themes emerged. We found that multisectoral approaches demand the often difficult reconciliation of competing and conflicting values and priorities. Across our three chosen cases, commercial interests and free trade agreements were the most common obstacles to successful multisectoral strategies. We found that early consultative stakeholder engagement and strong political and bureaucratic leadership were necessary for success. The complex multi-rooted nature of NCDs requires a multisectoral approach, but the inevitable conflicts that this entails requires careful navigation.

New methodology for identifying sustainable freshwater resources for the production of green hydrogen

ABSTRACT Managing sustainable and digital transformations in the water industry is a challenge. The identification of freshwater resources for green hydrogen production is necessary for the energy transition away from fossil fuels such as oil and gas. This can be achieved through the sustainable flood retention basin (SFRB) concept for identifying optimal locations for the retention of surface water. This unbiased concept helps in conflict resolution between stakeholders with water rights. Moreover, it serves as a simple tool to produce a digital water supply atlas based on dimensionless parameters with the short names’ population density, location advantage, precipitation, groundwater level, water rights, SFRB, excess running water and proximity to networks. While the first five parameters can be determined during a desk study, the last three parameters require site visits for verification purposes. Germany was used as a representative case study country to demonstrate the proposed methodology to obtain a water atlas based on mapped weighted values. The Kaiserstuhl in Germany served as a worked calculation example indicating well above average potential for water storage using existing retention basins. The water atlas can be used to supplement a (green) hydrogen atlas, supporting decision-makers in building hydrogen infrastructure.

Pajak Karbon sebagai Instrumen Kebijakan untuk Mendorong Transisi Energi dan Pertumbuhan Ekonomi yang Berkelanjutan

Energy transition and sustainable economic growth have become global priorities in addressing climate change. Carbon taxation has been recognized as one of the effective policy instruments in reducing carbon emissions and promoting the use of clean energy sources. However, the implementation and impact of carbon taxation are still subject to debate, particularly in the context of economic growth. Therefore, this research aims to investigate the role of carbon taxation in energy transition and economic growth, as well as identifying the associated benefits and challenges. The concept of carbon taxation and its impact on energy transformation are the main focus of this study. Within the concept of carbon taxation, the appropriate tax rate and effective design are crucial keys. Carbon taxation can provide economic incentives to reduce carbon emissions and encourage the use of clean energy sources. However, its implementation faces challenges such as uneven social impacts and international coordination. Case studies of countries adopting carbon taxation are also conducted to illustrate the real-life experiences and impacts of this policy. Carbon taxation has great potential in driving energy transition and sustainable economic growth. Through carbon emission reduction, increased utilization of clean energy, technological innovation, and revenue for investment, carbon taxation can bring significant benefits. However, challenges in implementation and international coordination need to be overcome. Inclusive supportive policies, proper tax design, and strong international cooperation are some recommendations to optimize the benefits of carbon taxation.&#x0D; Keywords: carbon taxation, energy transition, economic growth, carbon emissions, clean energy sources.

The effects of the COVID-19 pandemic on violations of the right to integrity of the person

The ongoing COVID-19 pandemic has been having a devastating impact on society not only from a health and economic perspective but also due to its direct and indirect effects on the human rights of citizens. In particular, the pandemic has had several negative effects on citizens’ right to integrity. For example, lockdown measures adopted by governments to manage the pandemic frequently resulted in increased levels of violence against women and girls; so much so that the UN body working on gender equality (UN Women) coined a new term—‘shadow pandemic’—to refer to the severe intensification of all forms of violence against women and girls that occurred during the pandemic, particularly domestic violence. In addition, in some cases, police officials have employed disproportionate force to ensure strict adherence to public health measures. Finally, hate crimes against individuals of Asian origin or descent have increased substantially in Western countries. However, and perhaps more surprisingly, there have been situations in which the pandemic, directly or indirectly, has seemingly led to a decrease in specific forms of violence. Researchers have, for instance, observed that at the height of the pandemic, there has been a decrease in reported cases of street violence against women, because of fewer people leaving their homes.Based on document analysis and a review of selected country case studies, this article aims to provide a thorough overview of the different types of violations of the right to integrity of the person that have emerged, worsened, or, possibly, decreased as a direct or indirect consequence of the COVID-19 pandemic. It focuses on three key types of violations: domestic violence, violence against women in public spaces, excessive use of force by law enforcement agents, and racial violence against individuals of Asian origin or descent. The article starts by introducing the right to integrity of the person and then focuses on the different forms of integrity rights violations that have emerged as a direct or indirect consequence of the pandemic. It concludes by reflecting on lessons learned and by providing some evidence-based recommendations on possible rights-infringement mitigation strategies during public health crises.

A Bayesian Approach to Estimate Maternal Mortality Globally Using National Civil Registration Vital Statistics Data Accounting for Reporting Errors

Estimation and monitoring of mortality, across multiple population-periods, is vital to improving national and global health outcomes. Reducing maternal mortality is a key part of the Sustainable Development Goals (SGDs), which commit countries and international agencies to monitor progress toward improvement of global maternal health outcomes. Country-specific estimates of maternal mortality are used for monitoring country progress. Civil registration vital statistics (CRVS) data provide valuable information on maternal mortality but are often subject to substantial reporting errors due to misclassification of maternal deaths or incompleteness of CRVS-reporting on deaths to women of reproductive age. Motivated by the challenge of estimating maternal mortality using error-prone CRVS data, this article introduces a Bayesian two-stage approach to obtain country-specific trends in maternal mortality ratios (MMRs), accounting for CRVS-related misclassification errors. In the first stage, we produce country-specific trends of CRVS-related data quality metrics, in terms sensitivity and specificity, through a Bayesian hierarchical misclassification model. In the second stage, we produce data-driven country trends in MMRs and proportion maternal deaths out of all-cause deaths, which are constructed using a Bayesian maternal mortality estimation model, accounting for CRVS-related data quality assessed in Stage 1. We present the approach to estimating maternal mortality and illustrate its use for several country case studies. This approach is used by the United National Maternal Mortality Interagency Group (UN-MMEIG) to produce maternal mortality estimates for global monitoring.

Pajak Karbon sebagai Instrumen Kebijakan untuk Mendorong Transisi Energi dan Pertumbuhan Ekonomi yang Berkelanjutan

Energy transition and sustainable economic growth have become global priorities in addressing climate change. Carbon taxation has been recognized as one of the effective policy instruments in reducing carbon emissions and promoting the use of clean energy sources. However, the implementation and impact of carbon taxation are still subject to debate, particularly in the context of economic growth. Therefore, this research aims to investigate the role of carbon taxation in energy transition and economic growth, as well as identifying the associated benefits and challenges. The concept of carbon taxation and its impact on energy transformation are the main focus of this study. Within the concept of carbon taxation, the appropriate tax rate and effective design are crucial keys. Carbon taxation can provide economic incentives to reduce carbon emissions and encourage the use of clean energy sources. However, its implementation faces challenges such as uneven social impacts and international coordination. Case studies of countries adopting carbon taxation are also conducted to illustrate the real-life experiences and impacts of this policy. Carbon taxation has great potential in driving energy transition and sustainable economic growth. Through carbon emission reduction, increased utilization of clean energy, technological innovation, and revenue for investment, carbon taxation can bring significant benefits. However, challenges in implementation and international coordination need to be overcome. Inclusive supportive policies, proper tax design, and strong international cooperation are some recommendations to optimize the benefits of carbon taxation.&#x0D; Keywords: carbon taxation, energy transition, economic growth, carbon emissions, clean energy sources.

Ketergantungan Ekonomi Pada Sektor Migas : Diversifikasi Sebagai Upaya Mengurangi Risiko Ekonomi

This research addresses the issue of economic dependence on the oil and gas sector and the efforts of economic diversification as a solution to reduce economic risks. We explain the benefits of economic diversification, such as economic stability and risk reduction, and provide case studies of countries that have succeeded in diversification. We also discuss the challenges and obstacles related to economic diversification, along with relevant policy recommendations. The findings highlight the importance of strategic measures in achieving more stable and sustainable economic growth.

Influence of Soft Power in shaping Diplomacy and Foreign Policy

This research delves into the evolving nature of power in international relations, focusing on the concept of soft power. Introduced by Joseph Nye in the 1990s, soft power is defined as the ability to influence others through attraction and persuasion rather than coercion or force. The study highlights how nations leverage cultural diplomacy, public opinion, and historical narratives to enhance their soft power and achieve foreign policy objectives. The article examines various methods through which soft power is projected, such as cultural exchanges, media influence, and the promotion of national values and ideals. It explores the role of non-state actors, including NGOs and multinational corporations, in shaping global perceptions and aligning foreign populations with a nation’s policies. Case studies of countries like China, Turkey, India, and the United States illustrate diverse approaches to employing soft power in international affairs. China’s strategic use of environmental diplomacy and Turkey’s deployment of the Turkish International Cooperation and Development Agency (TIKA) are highlighted as examples of how emerging powers utilize soft power to strengthen their global influence. The research also underscores the importance of integrating regional historical narratives and cultural elements into foreign policy to sustain diplomatic relations and promote national interests, with the depiction of the vibrant regional-historical narratives of India. By employing qualitative analysis, reviewing academic literature, policy documents, and specific national case studies to uncover patterns and strategies in the use of soft power, the findings reveal that effective soft power strategies are crucial for modern diplomacy, offering nations a means to project power and achieve foreign policy goals without resorting to military force. The article asserts that understanding and harnessing soft power is essential for navigating the complexities of global diplomacy in a multipolar world. By appealing the shared cultural values and fostering positive international relations, nations can enhance their global standing and influence through non-coercive means.

Research on the Impact of International Public Opinion on China's Outward Foreign Direct Investment—A Case Study of Countries along the Belt and Road

Research on the Impact of International Public Opinion on China's Outward Foreign Direct Investment—A Case Study of Countries along the Belt and Road

Introducing www.epidemic-em.org: A Collection of Online Resources and Training Materials for Strengthening use of Emergency Operations Centers for Epidemic Response.

This work aimed to demonstrate that a website, www.epidemic-em.org, encompassing "static" resources, and videos, as well as other tools, can be used to strengthen public health emergency management capacity during epidemic response. Existing resources were updated and developed for self-directed Emergency Operations Centers' capacity strengthening, in order to encompass current best practices, and to emphasize how public health emergency management concepts can support epidemic response activities. These materials formed the core of the website, launched in June 2020, to which country case studies were added. In 2021, a pilot virtual training program was designed using recorded video lectures and interviews with global experts in addition to the website material, which was delivered to South African responders. The website has been accessed in more than 135 countries, demonstrating widespread reach and interest in online and freely accessible materials to support public health emergency operations. Over 30 people participated in the pilot virtual training, and the evaluation showed improvement in knowledge, confidence in using emergency management concepts for epidemic response, and positive feedback on the virtual modality. Online tools can expand access to materials and resources for public health emergency management capacity strengthening. Virtual modalities can further serve as a powerful complement, and perhaps replacement, for traditional in-person technical assistance, despite some limitations.

Exploring the effects of digital technologies in health financing for universal health coverage: a synthesis of country experiences and lessons

Abstract The use of digital technologies (DTs) for health financing receives increased attention in policy, practice and research. However, not much robust evidence exists on their effects on the intermediate and final universal health coverage objectives. This paper seeks to contribute to evidence gathering, by synthesizing the findings from nine country case studies which covered diverse applications of DTs and identified their effects on health financing and universal health coverage objectives. This paper also draws on review papers on the use of DTs for health financing. Our synthesis reveals that DTs can support and simplify health financing tasks and thus contribute to enhanced efficiency and transparency and more equitable resource distribution. If well designed, DTs can help overcome challenges inherent in paper-based data systems and enable otherwise hardly implementable policy options, especially options that rely on near real-time exchange of data. Yet, the studies also point to various risks. Caution is for instance required when the use of DTs enhances inequities between population groups due to various digital divides. The findings point to a number of policy orientations. There is need to include the application of DTs for health financing in national digital health strategies and to develop health financing specific guidance and regulation. This is for instance necessary to avoid that DTs negatively affect financial protection. Clear stipulations related to equity will serve to ensure that positive effects accrue to vulnerable population groups. The future research agenda calls for more and methodologically robust evidence generation with a clear universal health coverage orientation.

How to evaluate a multi-country implementation-focused network: Reflections from the Quality of Care Network (QCN) evaluation.

Learning about how to evaluate implementation-focused networks is important as they become more commonly used. This research evaluated the emergence, legitimacy and effectiveness of a multi-country Quality of Care Network (QCN) aiming to improve maternal, newborn and child health (MNCH) outcomes. We examined the QCN global level, national and local level interfaces in four case study countries. This paper presents the evaluation team's reflections on this 3.5 year multi-country, multi-disciplinary project. Specifically, we examine our approach, methodological innovations, lessons learned and recommendations for conducting similar research. We used a reflective methodological approach to draw lessons on our practice while evaluating the QCN. A 'reflections' tool was developed to guide the process, which happened within a period of 2-4 weeks across the different countries. All country research teams held focused 'reflection' meetings to discuss questions in the tool before sharing responses with this paper's lead author. Similarly, the different lead authors of all eight QCN papers convened their writing teams to reflect on the process and share key highlights. These data were thematically analysed and are presented across key themes around the implementation experience including what went well, facilitators and critical methodological adaptations, what can be done better and recommendations for undertaking similar work. Success drivers included the team's global nature, spread across seven countries with members affiliated to nine institutions. It was multi-level in expertise and seniority and highly multidisciplinary including experts in medicine, policy and health systems, implementation research, behavioural sciences and MNCH. Country Advisory Boards provided technical oversight and support. Despite complexities, the team effectively implemented the QCN evaluation. Strong leadership, partnership, communication and coordination were key; as were balancing standardization with in-country adaptation, co-production, flattening hierarchies among study team members and the iterative nature of data collection. Methodological adaptations included leveraging technology which became essential during COVID-19, clear division of roles and responsibilities, and embedding capacity building as both an evaluation process and outcome, and optimizing technology use for team cohesion and quality outputs.

Юго-Восточная Азия и США: параметры взаимодействия

The article analyzes the factors influencing the nature of cooperation between Southeast Asian countries with the United States and the directions of its implementation in the context of the escalating rivalry between the United States and China, who seek to influence them. The US interest in the region is primarily determined by the tasks of containing China and strengthening its position in the Indo-Pacific region by expanding ties with partners and allies. The approach of the Southeast Asian countries towards cooperation with the United States is motivated by two considerations – strategic and economic. In the context of growing concerns about China’s expansion in the region and the persisting territorial disputes with it in the South China Sea, the United States in the eyes of these states is considered a stabilizing factor of the regional security system. The article points out that despite the fact that the Southeast Asian countries are interested in the presence of the United States in the region, the anti-Chinese orientation of American policy limits the potential of their strategic interaction. Case studies of individual Southeast Asian countries confirm their commitment to the principle of inclusiveness in foreign policy, which excludes choosing one party over the other. Despite the fears inherent in Southeast Asian countries about the expansion of China’s influence, they prefer to pursue a hedging policy, which in reality manifests itself in the desire to balance between competing parties in order to neutralize risks and preserve strategic autonomy. This explains the dualism of the Southeast Asian countries’ policies and affects their cooperation with the United States in the field of security, which, despite the intensification of diplomatic activities of Biden’s administration and the conclusion of a comprehensive strategic partnership agreement, is developing slowly, except for the ongoing joint military exercises and arms purchases. In general, the Southeast Asian countries are – and contribute to – solving problems they consider important, primarily in the field of economy. Contrary to the prevailing idea of China’s economic dominance in the region, the economic relations of the Southeast Asian countries with the United States have been stable for a decade, developing in an upward direction, and beneficial for the Southeast Asian countries themselves. Economic cooperation remains a priority of their interaction with the United States, despite the importance of developing security relations. Pragmatism and the acknowledgement of the emerging geopolitical situation in the region determines the parameters of interaction between the Southeast Asian countries and the United States.

Research on the Impact of the Development Level of Digital Economy on China’s Export Trade—A Case Study of RCEP Countries

Research on the Impact of the Development Level of Digital Economy on China’s Export Trade—A Case Study of RCEP Countries