Comprehensive Reform Research Articles

2.M. Workshop: Fostering integrated care through a large-scale structural health system reform in Finland

Abstract Several countries have introduced health system reforms to foster integrated care within their health systems and in some case also between health and other welfare services such as social care. These integrated care initiatives have included reorganization of the work of professionals, developing patient pathways and removing barriers for organisations to work together. Comprehensive structural reforms to foster integrated care have not been that common. In health systems, like in public policy in general, small, micro-level reforms are common but only seldom large-scale structural reforms are enacted. Also integrated care is often fostered through small-scale reforms which are not always even scaled up from the local or regional level to national level policies. In Finland a large-scale structural reform was introduced in 2023 which can be marked as one of the most comprehensive health system reform in Europe over the past decades. As a result of the reform the responsibility for organizing health care, social services and rescue services was transferred from over 300 municipalities to 22 health and social care authorities which all get funding from the state. A key tool in pursuing the reform has been to implement administrative and financial integration both in terms of vertical integration within health system and horizontal integration between health care and social services. The workshop uses the Finnish health system reform as a case study to present how integrated care can shape the health reform agendas and implementation of the reform. We discuss how structural reformation can foster integrated care at patient level and how the rather radical restructuration of the Finnish health system looks from the wider European perspective. Key messages • One of the most comprehensive health-system reforms in Europe over the past decades was introduced in Finland in 2023. • The radical structural health-system reformation can foster integrated care at patient level and offers a learning opportunity to other European health systems.

Can a Developmental Education Reform Promote Momentum to Mid-Term and Longer-Term Student Success? Evidence from Florida

Developmental education reform has shown promising evidence toward improving short-term outcomes, yet questions remain about whether these early gains contribute momentum toward mid-term and longer-term postsecondary success. In 2014, Florida implemented one of the nation’s most comprehensive developmental education reforms. Many students became exempt from college placement testing and could enroll directly in college-level courses. Nonexempt students were still required to take developmental education courses if they scored below college-ready, but the colleges were required to offer these courses using accelerated instructional strategies such as corequisite courses. Colleges also had to develop enhanced advising and academic support services. Statewide student-level data is used in an interrupted time series design to examine trends in persistence, credit accumulation, transfer, and credential completion before and after Florida’s developmental education reform. While there are little to no differences in outcomes for the overall sample before and after the reform, there are positive associations between the reform and mid- or longer-term outcomes among students who are nonexempt from college placement testing and must participate in accelerated developmental classes if they score below college ready.

Educational philosophy for Vietnam in the present era

The present era witnesses rapid advancements in science, technology, and unforeseen transformations that impact all dimensions of the global economy and society, including Vietnam. Consequently, a comprehensive reform of the education system becomes necessary to address the evolving developmental requirements. This reform encompasses multiple aspects such as organizational structure, administrative management, curriculum content, teaching methodologies, and quality assurance. To navigate the changing landscape effectively, the establishment of an educational philosophy that can guide the activities of educational institutions within the national education system becomes imperative. This article acknowledges the crucial need, given the current state of education, to formulate an educational philosophy that will provide direction for Vietnam's education in the new contextual landscape.

Towards a New Understanding of Swedish School Reforms: A Sociological Analysis of Textbooks’ Role in Reforms of School Mathematics, 1919–1970

This article sheds new light on the Swedish comprehensive school reform implemented in the 1960s (the Grundskolan reform) and the four decades preceding the reform. This reform was typical for the Nordic countries. The presented study concerns reforms in mathematics education and how change was initiated and driven before and during the comprehensive school reform. The analysis has a focus on the role of textbooks in educational governance. The analysis is based on Bourdieu’s field theory and concerns how a new way of preparing and driving reforms of school subjects restructured relationships between the state, textbook producers, and teachers. This article is mainly a synthesis of results from several previous studies on governance of Swedish mathematics education. The analysis reveals not only a new characteristic of the comprehensive school reform (swift and radical rather than slow and successive), but also a bottom-up movement in the school system, which has been commonly understood as top-down, very centralised, and slow moving. The results of the analysis help explain why the Swedish comprehensive school reform gained early acceptance and momentum. Another contribution of this article concerns historical textbook research, particularly regarding how fundamental changes in authorship of textbooks (from visible individual authors to anonymous collectives) can be related to educational governance and changes in power structures.

Assessing Determinants of Shifting Attitudes on Drug Policy Reform in Maine

There is growing recognition that our decades-long “war on drugs” has not only been a policy failure but has made our societal drug crisis worse. This is painfully evident in our response to the opioid epidemic. Efforts at comprehensive policy reform are likely to emerge first at the state and local levels. We collaborated with policy advocates and practitioners to study policy perspectives of registered Maine voters, and to investigate determinants of receptivity to drug policy reforms rooted in decriminalization and harm reduction. Our results suggest that while political ideology still impacts one’s perspective on these issues, increased exposure to those with substance use disorder reduces stigma, resulting in increasingly broad, bipartisan support for policy reform. We conclude with a discussion on how policymakers addressing overdose and substance use disorder at the state and local level should consider implementing and funding evidence-based alternative approaches such as decriminalization and harm reduction.

The ‘Organized Anxiety’ of Labour Leader Nannie Helen Burroughs

Educator and labour leader Nannie Helen Burroughs and her colleagues at the National Association of Colored Women’s Clubs (NACW) experienced ‘organized anxiety’ during the early twentieth century as they worked to establish a comprehensive labour reform movement in the United States. Burroughs’ colleague and NACW leader Fannie Barrier Williams coined the term ‘organized anxiety’ to describe Black women’s politicized emotions that fuelled their expansive organization as they worked to build a truly democratic society. NACW members, such as Burroughs, integrated their fight for labour rights into their larger movement for women’s suffrage and civil rights. Burroughs established a school and women’s organizations to challenge ideologies and institutions that confined Black women to low-wage service work and denied them full citizenship rights. In this article, I draw from Hochschild’s emotional labour theory, which brings women’s ‘invisible’ work into view, and Williams’ organized anxiety concept to examine Burroughs’ unrecognized, yet critical work of developing and leading a labour reform movement for Black women in a country that denied their very humanity.

The combination of intelligent depression prevention education system in universities and olanzapine tablets on students’ learning phobia

Background Learning phobia has long been a key obstacle in the field of higher education, hindering students’ successful development. This study proposes an innovative educational ecosystem that combines intelligent technology with olanzapine treatment, aiming to significantly reduce students’ learning anxiety and create conditions for better academic achievement.Subjects and Methods The study recruited students from several universities who had been diagnosed with learning phobia. To assess their symptoms and performance, several standardized tools were used, including the Stanford Acute Stress Response Questionnaire (SASRQ) and the 3-Minute Disorder Assessment Scale (3D-CAM). In order to process and analyze the collected data, SPSS23.0 software was used. The software can help researchers organize, calculate, and analyze data in order to come up with relevant results about learning phobia. Through these assessment tools and statistical analysis, researchers can better understand the characteristics and influencing factors of learning phobia and provide a basis for further research and treatment.ResultsStudents who used olanzapine tablets in combination with an intelligent depression prevention system showed significant improvement in self rated learning anxiety (SASRQ) and clinical observation measurement (3D-CAM) scores, which was significantly reduced compared to students who only received traditional teaching methods.ConclusionsIntegrating olanzapine treatment into the comprehensive education reform of the intelligent depression prevention system provides promising potential for positively influencing students’ learning phobia. This method marks a crucial step towards advancing educational strategies and promoting good mental health among students.

Combining lamotrigine tablets on students with bidirectional emotional disorders in the context of educational psychology in higher education teaching reform

BackgroundThe potential of comprehensive educational reforms, backed by principles of educational psychology, to positively impact bipolar disorder students is underexplored. Combining such strategies with medical treatment, such as risperidone, might further enhance positive psychological effects. This study hypothesizes that such a synergistic approach can optimize teaching methods and improve the mental health landscape in higher institutions.Subjects and MethodsWe utilized a mixed-methods approach in this non-randomized controlled trial. Study participants included students diagnosed with bipolar disorder across different universities and currently under risperidone treatment. Our research tools included standardized measures such as the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), as well as the General Self-Efficacy Scale (GSES). Data were collected and analyzed using SPSS23.0.ResultsA statistically significant improvement was observed in the student participants’ psychological well-being signs, attributed to the educational reform combined with risperidone treatment. These alterations demonstrated substantial improvements in YMRS and HDRS scores, manifesting reduced manic and depressive symptoms. Furthermore, higher GSES scores reflected enhanced self-efficacy.ConclusionsEducational reform that accommodates the unique learning needs of students with bipolar disorder, combined with risperidone treatment, seems to result in significant positive psychological effects. This study underscores the potentially valuable cross-disciplinary approach to addressing mental health issues within higher education institutions.

Digital finance application design under drug intervention on quality of life of patients with organic mental disorders

BackgroundWith the rapid development of the Internet, psychiatric patients are inevitably exposed to related applications of digital finance. The research will explore the impact of digital finance applications on the quality of life of patients with organic mental disorders under drug intervention.Subjects and MethodsThe study will select 98 patients with organic mental disorders admitted to a certain hospital from January 2021 to January 2022 as the data for the study. The patients will be randomly divided into an observation group and a control group, and the improvement of the total quality of life score (SQLS) of patients who are not exposed to digital financial applications, one month and three months after exposure, with and without drug intervention, will be calculated.ResultsThe total SQLS scores of patients who underwent drug intervention were higher than those of corresponding patients who did not undergo drug intervention; Among patients who underwent drug intervention, after 1 month and 3 months of exposure to digital finance applications, the total SQLS score was lower than that of the control group; The total SQLS score of patients in the observation group was lower than before exposure to digital finance applications; After 3 months of comprehensive nursing, the total SQLS score of the patient was significantly lower than that after 1 month of comprehensive nursing intervention.ConclusionsUnder drug intervention, exposure to digital finance applications can affect the quality of life of patients with organic mental disorders, and the impact becomes more pronounced with the extension of exposure time. In clinical psychiatric care, patients should reasonably arrange the duration of exposure to digital finance applications.AcknowledgementThe research is supported by: 2023 Education Reform of Xi’an University: Comprehensive Reform Project of Economics and Finance (No. 07-1021517).

Vietnam's foreign policy with ASEAN: A national interest approach (1986- 2020)

In 1986, Vietnam initiated the Doi Moi policy, marking the onset of comprehensive reforms in economic, political, diplomatic, and societal dimensions. This reform agenda established a foreign policy framework prioritizing national interests. Amid the ever-evolving global and regional economic and political landscape, Vietnam proactively adapted to these shifts. Crafting foreign policies guided by the Party Congresses and Politburo Resolutions, Vietnam accentuated diplomatic ties with neighboring nations and the ASEAN community as paramount priorities. Notably, Vietnam's foreign strategies emanate from a rigorous consideration of national interests. This article conducts an exhaustive analysis of Vietnam's foreign policy vis-à-vis ASEAN, emphasizing the national interest approach during the years 1986 to 2021. Through rigorous examination and reliance on substantiated evidence, the author discerns that Vietnam's engagements with ASEAN are meticulously designed to safeguard primary, secondary, and shared national interests. Nevertheless, Vietnam encounters formidable challenges and complexities in its pursuit of these national interests within the ASEAN framework.

Проблема дробления бизнеса и необходимость комплексного реформирования налогового законодательства

A concept has been presented for a comprehensive reform of the simplified taxation system and of its related areas, including VAT and liability for breaching tax legislation. The reform is designed to keep the problem of splitting up a business to a minimum, to provide for a switch from the special to the general tax treatment, and to fine-tune the simplified taxation system to meet today’s demands of the development of small business and of Russian economy in general.

DIDACTIC POSSIBILITIES OF IMPROVING THE SYSTEM OF EDUCATION OF YOUTH IN THE SPIRIT OF MILITARY PATRIOTISM IN ACADEMIC LYCEUM STUDENTS

In the conditions of the digitized society, there is an increasing need to improve the system of educating young peoplein the spirit of military patriotism in accordance with the requirements of training modern specialists in our country, to implement comprehensive reforms in the field of scientific research related to education and training at the international level, touse the latest achievements of science and technology, in the process of training mature scientific-pedagogical personnel, increasing the use of scientific knowledge in training sessions, strengthening the active use of potential, mature future specialists in production, economic-social, spiritual activities, and improving the national education system requires modernization.

Economic reform in Iraq after 2014 (obstacles and prospects)

The study deals with the difficulties facing the economic reform process in Iraq, in light of the economic and political challenges that the country faces, particularly since 2014, as a result of the dual crisis that afflicted the Iraqi economy, as a result of the dominance of ISIS gangs over a third of the area of Iraq, in addition to the sharp decline in oil prices.
 The process of economic reform in Iraq faces many obstacles, foremost of which is the rentier nature of the Iraqi economy and the spread of corruption, in addition to the poor infrastructure and the decline in foreign investments.
 In order to achieve effective economic reform in Iraq, comprehensive reform measures should be implemented aimed at improving economic conditions, improving infrastructure and attracting foreign investments, in addition to combating corruption and dealing with structural obstacles that impede the process of economic reform in Iraq. This requires enhancing transparency and improving financial and banking management, as well as strengthening the capacities of governmental and private institutions to participate in the economic reform process.

Corporate tax reform in the European Union: are the stars finally aligned?

Abstract Are the stars finally aligned as far as corporate tax reform in the European Union (EU) is concerned? Tax reform in the EU has always been a contentious issue, as taxation was always considered one of the last bastions of national sovereignty. This article examines whether this is still the case or whether, in light of recent initiatives and proposals in this area, conditions are now ripe for comprehensive reform. The article begins by reviewing the historical trajectory of EU corporate tax law. It is shown that whilst early harmonization proposals were very ambitious, the overall constitutional set-up and the fiscal veto were not conducive to comprehensive reform. What followed these early initiatives was an era of pragmatism and slow progress, which, nevertheless, laid the foundations for important developments. Apart from the ad hoc legislative tax instruments that were agreed upon in the last 30 years to further the internal market and remove obstacles to cross-border movement, this article focused on the Commission’s ongoing work on a common tax base and consolidation, as well as other recent legislative initiatives such as the now enacted Directive on a Minimum Effective Tax Rate and the Unshell proposal. In light of these crucial developments, with all their strengths and weaknesses, it is argued that what was once considered as far too ambitious a proposal indicative of a federal Europe, now has high chances of materializing in the context of the BEFIT initiative (Business in Europe: Framework for Income Taxation). This is to be welcomed, as it is the next organic step to take in the process of EU integration. Whilst the stars may not yet be fully aligned, it is argued that what is needed at this point in time, is a change of mindset and a realization that Member States’ tax sovereignty has long been eroded.

The Institutional Origins of the Ming and Qing Imperial Examinations􀆳 Special Classics Examination Model, the Separation of Scripture Reading and the Reform of Accumulated Disadvantages

Confucianism has always been the main content of the ancient imperial examinations, and the types and scope of the examination of classics have had a significant role in inducing scholars to study the classics. In the Ming and Qing dynasties, the imperial examinations adopted the mode of selecting one of the five classics as the special classics examination, which not only had a long institutional origin and historical evolution, but also produced the system of marking the classics in the implementation of the operation. In order to better select officials and maintain the feudal rule, based on the numerous disadvantages derived from the long-term operation of the special scripture test, the Qing court adopted the reform. of the mode of trying classics, changing the special scripture test for the five classics and test. This reform. and adjustment of this trial mode has an important and unique historical mirror value for promoting the comprehensive reform. of the college entrance examination in the new era.

Current Legal Management in Drug Retail by Private Retailers in Vietnam

Aim: This article aims to analyze the current state of private drug retailers in Vietnam's lower-middle-income context, investigating the causes and consequences of inadequacies in drug retail practices. The study intends to offer effective solutions to address these issues and serve as a reference for other lower-middle-income countries facing similar challenges. Method: Employing data gathered from documentation, legal analysis, and comparative methods, this study examines the state of drug retail by private retailers in Vietnam. By analyzing the existing practices and regulations, the study identifies the factors contributing to the inadequacies in the drug retail sector. Implications: The research reveals substantial inadequacies in the drug retail sector in Vietnam, stemming from a lack of robust regulations, inadequate oversight, and other systemic issues. These inadequacies have significant adverse effects on consumer health and the overall economy, hindering sustainable development efforts. Addressing the inadequacies in drug retail in lower-middle-income countries like Vietnam requires comprehensive regulatory reforms, improved oversight mechanisms, and enhanced collaboration between government agencies and private sector stakeholders. Results and conclusion: By rectifying these issues, countries can better protect the health and well-being of their citizens while fostering an environment conducive to sustainable development. This study's findings and recommendations offer valuable insights for other LMICs grappling with similar challenges in their drug retail systems.

Knowledge, Awareness, and Understanding of Pediatric Triage Among Nursing Officers in India: A Multicenter Study.

Triage is crucial in patient screening within emergency departments (EDs) worldwide. It is one of the essential and standard medical practices in many developed countries. However, in India, there is a need for improvement in triage utilization, as it is predominantly performed by resident doctors or medical officers, leading to an uneven distribution of clinical skills among healthcare providers (HCPs). A comprehensive analysis incorporating literature review and data collection revealed that while mandatory screening is conducted in most Indian EDs, the formal implementation of standardized triage protocols remains limited. Like in developed countries, registered nurses or nursing officers (NOs) can be effectively trained and directed to play the role of dedicated triage personnel in EDs of most of the healthcare facilities in India. This study aimed to examine the current state of triage utilization and its impact on the distribution of responsibilities among HCPs in Indian EDs. Through this online survey, the investigatorsassessed the knowledge and practical understanding of clinical triaging among NOs, working at various hospitals nationwide. The participants included 5,029 NOs working in various parts of India, predominantly nursing graduates (82.52%), the majority being employed in government healthcare settings (84.01%)and most having over five years of cumulative working experience in the ED (70.77%). Nurses showed inadequate knowledge and awareness about the Pediatric Assessment Triangle (PAT) used for quick initial evaluation (62.18%amongall participants). Concerning the complete triage process applicable, especially in pediatric ED settings, they had even less satisfactory knowledge and understanding, e.g., identifying primary (28.27%) and secondary (22.69%) survey components via focused history and examination, properly using temperature assessment (23.32%) and instant blood glucose level assessment (22.95%) in triage, and knowing various types of internationally accepted triage systems for ED-based health facilities such as the Emergency Severity Index (ESI), Canadian Triage and Acuity Scale (CTAS), and Australasian Triage Scale (ATS) (15.87%). ANOVA and post hoc analysis revealed that the intergroup performance of the study participants with maximum correct responses to the knowledge-determining specified subset of the questionnaire depicts the significantly higher role of graduate nursing degree over diploma such as General Nursing and Midwifery (GNM)/Auxiliary Nursing and Midwifery (ANM) qualification, working in government hospital versus private setup, and ED working experience of >5 years over that of <5 years. Of the participants in the study, 50% were not evaluated for cognitive or psychomotor domains during their assessment examinations. The research illuminated a significant disparity in knowledge and proficiency levels among Indian nurses concerning pediatric triage, especially with the ability to effectively apply the PAT for initial patient evaluations, discern components of primary and secondary surveys, and comprehend various triage systems. This study underscores the importance of comprehensive reform in the Indian healthcare system and teaching curriculum by emphasizing clinical triage training and interprofessional collaboration, and establishing guidelines and regulations to ensure consistent and standardized triage practices across all EDs.

The Economic Impact of Banning Billionaires: An Analysis of Wealth Accumulation and Market Dynamics

This article examines the issue of banning billionaires and provides a comprehensive analysis of potential policy implications. First, the article discusses the possible negative impact of banning billionaires on innovation and the spirit of adventure, highlighting their important role in funding support, venture capital and high-risk projects. Second, the article analyzes the potential adverse effects of banning billionaires on charitable giving and philanthropy, as well as the possible impacts on economic growth and job opportunities. Finally, the article points out that the prohibition of billionaires is not the same as eliminating the upper class of society, stressing that solving social inequality requires more comprehensive policies and systems Sex reform.

Assessing the Impact of Different Agricultural Irrigation Charging Methods on Sustainable Agricultural Production

China is currently experiencing severe water scarcity issues in its agricultural production sector. To address this challenge, the Chinese government has taken steps towards implementing a nationwide reform in agricultural water pricing to accelerate the more sustainable management of the agricultural water resources sector. The present study adopted a multiple regression model to test four alternative irrigation water charging methodologies (charges based on ladder pricing, time, land area, and electricity) accompanied by supportive agricultural pricing policies to address the inherent conflicts between water conservation and agricultural development goals. This study focused on the Wei River Basin, which is recognized as a highly water-stressed region in China. This basin was chosen as a pilot area for comprehensive reform initiatives related to agricultural water pricing and served as the geographical scope for our research. Between June and July of 2022, we conducted comprehensive field surveys within the Wei River Basin, accumulating a dataset of 415 data points pertaining to the crop year of 2022. Our results showed that the ladder water price-based method exhibited remarkable potential in achieving substantial savings, with a minimum of 60.5239 m3/mu of irrigation water conserved for food crops and an impressive 67.8090 m3/mu for cash crops. However, regarding water-saving irrigation technologies, the estimation results indicated that electricity-based charging outperformed the other methods, resulting in an impressive 55.22% increase when ladder pricing served as the benchmark. In addition, regarding agricultural green production, the results for food crops and cash crops are different, with food crops being more sensitive to the ladder water price policies. Moreover, the results suggested that different water charging methods have significant heterogeneity effects from the perspective of the farmers’ scale, land fragmentation, and water price awareness capacity. This study forges an innovative path for water-stressed nations to execute agricultural water pricing reform and enhance agricultural production’s sustainable growth.

Study on the Temporal and Spatial Evolution Characteristics of Chinese Public's Cognition and Attitude to “Double Reduction” Policy Based on Big Data

The “double reduction” policy is a policy innovation of China's comprehensive education reform to build a high-quality education system. The public's cognition and attitude toward it are of great significance to its actual implementation. A total of 98396 texts related to “double reduction” collected from Sina-Weibo by web crawler technology are investigated to explore the public's cognition and attitude towards the “double reduction” policy as well as its spatio-temporal evolution characteristics. Guided by life cycle theory, the evolution of the public's attitude is studied by sentiment analysis based on the ERINE algorithm and DUTIR. Topics are selected with the adoption of TF-IDF and LDA models to perform spatio-temporal evolution of public cognition and analyze group differences. The results are as follows: the evolution of public concern about the “double reduction” policy is phased and the period of high incidence is closely related to time nodes such as policy release, the new school term, and holidays. There are temporal and spatial differences in the evolution of public attitudes between different stages and groups. Although the public holds a relatively negative attitude, with more information about the “double reduction” policy available, the public's attitude is gradually easing. Topics of public concern vary in different periods, and different groups show different emotional attitudes and have distinctive evolution characteristics of cognitive themes. Compared with other age groups, teenagers pay more attention to topics related to their studies and life. The government's official micro-blog not only shoulders the responsibility of publicizing relevant policies, but also pays close attention to the implementation of relevant policies around the country. The influential groups hold a relatively firm attitude and stable emotions and often can orient public opinions. The regional attention to the “double reduction” policy is positively correlated with the level of local economic development. The research results can help government departments learn about the public's cognition and attitude towards the “double reduction” policy to provide decision-making support, and serve as an important basis for solving existing contradictions and promoting the effective implementation of policies.