Institutional Characteristics Research Articles

Impact of Institutional Practices and Surgical Complexity on Sarcoma Surgery Costs: Driving Efficiency in Value-Based Healthcare.

Sarcomas present a unique challenge within healthcare systems due to their rarity and complex treatment requirements. This study explores the economic impact of sarcoma surgeries across three Swiss tertiary healthcare institutions, utilizing a consistent surgical approach by a single surgeon to eliminate variability in surgical expertise as a confounding factor. By analyzing data from 356 surgeries recorded in a real-world-time data warehouse, this study assesses surgical and hospital costs relative to institutional characteristics and surgical complexity. Our findings reveal significant cost variations driven more by institutional resource management and pricing strategies than by surgical techniques. Surgical and total hospitalization costs were analyzed in relation to tumor dignity and complexity scores, showing that higher complexity and malignancy significantly increase costs. Interestingly, it was found that surgical costs accounted for only one-third of the total hospitalization costs, highlighting the substantial impact of non-surgical factors on the overall cost of care. The study underscores the need for standardized cost assessment practices and highlights the potential of predictive models in enhancing resource allocation and surgical planning. By advocating for value-based healthcare models and standardized treatment guidelines, this research contributes to more equitable and sustainable healthcare delivery for sarcoma patients. These insights affirm the necessity of including a full spectrum of care costs in value-based models to truly optimize healthcare delivery. These insights prompt a reevaluation of current policies and encourage further research across diverse geographical settings to refine cost management strategies in sarcoma treatment.

Motherhood Penalty Revisited: Impacts of Maternity Leave Mandates on Nature of Employment Contracts

In this paper we study the extension of paid maternity leave from 12 weeks to 26 weeks in India to estimate its effect on the contractual arrangements of working women. To identify causal effects, we exploit the variation generated by the institutional features of the policy mandate in India, which applies only to establishments employing 10 workers or more. We find that women are 4.3 percentage points less likely to be employed as regular salaried workers in the establishments as a result of this policy. We also show that there is an increase in the employment of women as unpaid and wage labourers in establishments, but no change takes place in women entrepreneurship. The effects appear to be driven by married and younger women confirming that the extension of maternity leave imposes a motherhood penalty in terms of women’s labor market opportunities.

The crypto world trades at tea time: intraday evidence from centralized exchanges across the globe

AbstractIt is a stylized fact that trading activity, volatility and liquidity in equity and other financial markets follow specific intraday patterns. These patterns are to a large extent determined by institutional features such as exchange trading hours or batch settlement procedures. We analyze the intraday patterns that emerge when these institutional constraints are absent. We compile a large sample of 1940 currency pairs traded on 38 cryptocurrency exchanges located on five continents. These exchanges operate 24 h a day, seven days a week, and settle trades instantly. We find that there are pronounced time-of-day patterns in trading activity, volatility and liquidity. These patterns are remarkably similar across exchanges, time zones and cryptocurrency pairs. Specifically, trading activity, volatility and illiquidity all peak between 16:00 and 17:00 Coordinated Universal Time (UTC), i.e. during U.K. tea time. We find that characteristics of the exchanges (such as their locations) and of the traded currency pairs (e.g. whether two pairs share a common currency) explain some, but not all of the commonality in intraday patterns.

Vocational teachers as policy actors

Linguistic diversity has become a focus in the Norwegian National Curriculum (LK20), which establishes students experiencing “multilingualism as a resource” as a policy intention. This study explores if and how this policy intention corresponds with teachers’ experiences and practices in mainstream vocational education and training (VET). Using the concept of policy enactment developed by Ball et al. (2012) as a theoretical and analytical framework, I analyze the curricular aims set by the LK20 Core Curriculum and a subject-specific VET curriculum, comparing them to the teaching practices reflected in interview data gathered through linguistic ethnographic fieldwork in mainstream Norwegian VET programs in 2020 and 2021. My findings show that (a) the National Curriculum positions vocational teachers as subject-specific, mainly Norwegian-oriented language teachers held to ensure the enactment of “multilingualism as a resource”, even though most vocational teachers are not trained in language education, and that (b) vocational teachers act as interpreters, translators, and relatively passive receivers of language-related policies, also frequently assuming critical positions towards these policies and some organizational features of the educational institution. The study highlights the ambiguous and challenging positions vocational teachers find themselves in, emphasize the necessity of more multilingually-oriented approaches to mainstream vocational education, and show that for language-related policy intentions like “multilingualism as a resource” to be enacted, it is imperative to provide policy actors like vocational teachers with sufficient suitable resources.

The Impact of Agency Problems on Corporate Performance in China

This paper delves into the intricate dynamics of the horizontal agency problem within the realm of corporate governance in China, scrutinizing the inherent conflict of interest between controlling and minority shareholders amidst a backdrop of concentrated ownership. Its core objective is to comprehensively grasp the repercussions of this agency dilemma on firm value and corporate performance. Central to this investigation is the identification and analysis of institutional features that fuel the agency predicament, notably the pre-existing split-share structure and the prevalent establishment of pyramid ownership arrangements. In response to these challenges, this study advocates for two primary approaches to mitigate the agency conundrum: an informal approach driven by cultural factors, particularly rooted in Confucian ethics, and a formal strategy entailing robust legal safeguards and regulatory frameworks. The potential efficacy of these proposed measures in ameliorating conflicts of interest, curbing unethical conduct, and fortifying the rights of minority stakeholders, all while reducing agency costs and enhancing corporate performance.

History and evolution of the healing gardens: Investigating the building-nature relationship in the healthcare setting

Healing gardens, a longstanding feature of medical institutions, have garnered attention from scholars for their health-promoting properties across various stages of research. Through a historical literature review and contemporary case analysis of healing gardens, this research investigates how to achieve therapeutic integration by fostering effective connections between buildings and nature through typological design. Combined with qualitative and design-driven research methodologies, including the use of visualization tools such as drawings, models, and images, six models of building-nature integration in contemporary healthcare architecture are identified. This article bridges a research gap in the field of healing garden design and concludes by demonstrating that “typology” is only a design strategy according to context and building performance. In addition to positions of healing gardens, critical factors such as spatial organization, aesthetics, and sustainability, incorporating elements such as accessibility, readability, comfort, and ecological factors, must be carefully considered to achieve integration.

Document analysis of adaptive sport opportunities at Division-1 universities in the United States

BackgroundIndividuals with disabilities are less likely to participate in physical activity, with the greatest decline in participation during college years. Despite known health benefits, there are significant barriers that limit sport and exercise participation for students with disabilities, including adaptive access. To our knowledge, there has been no comprehensive review conducted to examine the number of adaptive sport offerings on a collegiate level. ObjectiveAssess the availability of adaptive sport opportunities for students at National Collegiate Athletic Association (NCAA) Division-1 Universities to better understand university-affiliated adaptive sport opportunity for students. MethodsWebsite document analysis was conducted by systematically querying the general homepage, athletics page, and campus recreation websites of each NCAA Division-1 University in the United States (US). Institutional and sport-related characteristics were recorded. ResultsOf the 358 NCAA Division-1 Universities, 20.4 % (73/358) marketed adaptive sport opportunities (recreational, club, and/or intercollegiate), with 3.9 % (11/358) acknowledging intercollegiate adaptive sport programs on their websites. Five percent (6/121) of private institutions, and 28.3 % (67/237) of public institutions reported adaptive sport opportunities. The Northeast region had the fewest number of institutions reporting adaptive sport offerings (4/67, 6.0 %). The most commonly offered sport was adaptive recreation (36/358, 10.2 %), followed by wheelchair basketball (26/358, 7.4 %). ConclusionOver three-quarters of Division-1 Universities in the US lack an online description of adaptive sport opportunity, highlighting the need for expanded resourcing and marketing of adaptive sport at the university level. Future studies are necessary to identify appropriate strategies to effectively promote sport, maximize participation and improve social inclusion.

The zero-debt puzzle in BRICS countries: Disentangling the financial flexibility and financial constraints hypotheses

This study analyzes the zero-debt decisions of BRICS firms using a bivariate probit model. The leading hypotheses are financial flexibility and financial constraints. On the demand-side, our findings reveal that managerial debt aversion, early lifecycle stage, growth opportunities, solvency, and concentrated ownership contribute to the lack of debt. Similarly, a country's institutional quality correlates with firms' debt-free status. On the supply-side, creditors fund companies with poor financial records in countries with robust markets and economic freedom. Financial flexibility and restrictions leading to zero debt are linked to firm and institutional characteristics in emerging countries.

Factors affecting coffee farmers’ access to financial institutions: The case of Bandung Regency, Indonesia

Abstract The development of coffee plants in Indonesia shows increasingly rapid growth to meet both domestic and foreign needs. However, certain farmers are yet to fully utilize their cultivation technology and market opportunities by employing post-harvest techniques to enhance value addition, primarily because of limited access to farming capital. Therefore, this research aimed to identify the potential sources of farming capital and determinant factors in choosing farming sources. In this experiment, the population of coffee farmers in the Pangalengan Subdistrict was surveyed. The sampling method was a proportional random sampling technique based on 235 respondents. To answer the first objective, descriptive analysis was used, while logit regression analysis was carried out for the second objective. The results showed that most farmers (54.66%) depended on internal capital, while the rest used external capital such as banks (28.39%), non-banks (1.69%), and non-formal financial institutions (15.25%). Characteristics of informal non-financial institutions, especially unsecured loans, include repayment in the form of coffee or money, with repayment terms typically set at harvest time. Conversely, formal institutions offer loans with an interest rate of 9% per annum, requiring collateral in the form of securities, and repayment is typically made on a monthly or quarterly basis. In short, factors influencing farmers in accessing credit from financial institutions are the farmer’s age, number of coffee trees, distance to financial institutions, coffee farming income, education, and credit payment deadlines.

A systematic review of students’ habitus in the higher education field: challenge and resilience

ABSTRACT To contribute to the student transition theory and practices through the lens of habitus, this systematic review identifies three prevailing trends and features of the existing literature: non-traditional students in the spotlight and comparisons with traditional students; heterogeneity among non-traditional students (different mechanisms and layers); and the ecology of fields and habitus intertwined with reflexivity, agency, and identity. By categorizing different student groups and comparing their habitus-related problems, responses to those problems, and relevant factors, it reveals the predominant research focus on non-traditional students and problematizes the oversimplified classification of them. Non-traditional students with socioeconomic status (SES)-based, sociocultural origin (SCO)-based, and educational habitus diverge. Moreover, it considers students’ habitus in the ecology of environmental systems, which involve various contexts (e.g. nation, local community, institution, program, etc.), actors (e.g. faculty, staff, peers, family members, etc.), and elements (e.g. previous schooling, intangible features of HE institutions, etc.). Nuanced understandings of differences between habitus transformed to adapt to or transcend the higher education (HE) field, and the complex interplay between habitus and identity are also solicited. These contribute to acknowledging the dynamic transitions of heterogeneous students better and providing practical implications for HE institutions to facilitate student transition, especially non-traditional students’ development, in a tailored manner.

Follow-up computed tomography and unexpected hemostasis in non-operative management of pediatric blunt liver and spleen injury.

While follow-up CT and prophylactic embolization with angiography are often conducted during non-operative management (NOM) for BLSI, particularly in a high-grade injury, the utility of early repeated CT for preventing unexpected hemorrhage remains unclear. This study aimed to elucidate whether early follow-up computerized tomography (CT) within 7 days after admission would decrease unexpected hemostatic procedures on pediatric blunt liver and spleen injury (BLSI). A post-hoc analysis of a multicenter observational cohort study on pediatric patients with BLSI (2008-2019) was conducted on those who underwent NOM, in whom the timing of follow-up CT were decided by treating physicians. The incidence of unexpected hemostatic procedure (laparotomy and/or emergency angiography for ruptured pseudoaneurysm) and complications related to BLSI were compared between patients with and without early follow-up CT within 7 days. Inverse probability weighting with propensity scores adjusted patient demographics, comorbidities, mechanism and severity of injury, initial resuscitation, and institutional characteristics. Among 1320 included patients, 552 underwent early follow-up CT. Approximately 25% of patients underwent angiography on the day of admission. The incidence of unexpected hemostasis was similar between patients with and without early repeat CT (8 [1.4%] vs. 6 [0.8%]; adjusted OR, 1.44 [0.62-3.34]; p = 0.40). Patients with repeat CT scans more frequently underwent multiple angiographies (OR, 2.79 [1.32-5.88]) and had more complications related to BLSI, particularly bile leak (OR, 1.73 [1.04-2.87]). Follow-up CT scans within 7 days was not associated with reduced unexpected hemostasis in NOM for pediatric BLSI.

Advertising and Content Differentiation: Evidence from Youtube

Abstract Many media outlets depend on advertising revenue to finance their operations, but the effect of advertising on media outlets’ content choice is largely unexplored. This paper exploits two institutional features from YouTube to show that an exogenous increase in the feasible amount of advertising induces YouTubers to differentiate their video content from their competitors. A plausible mechanism is that YouTubers avoid competition: Viewers typically perceive advertising as a nuisance and therefore as an implicit price they have to pay; thus, they could switch to a competitor if a YouTuber increased her advertising quantity. This is less likely, however, if the YouTuber differentiates her content from the mainstream and moves to a niche.

INSTITUTIONAL FACTORS OF THE TECHNOLOGIC ACADEMIC ENTREPRENEURSHIP DYNAMICS

The article deals with identifying the obstacles to the commercialization of academic research results generated by the differences in institutional environment for the production of scientific knowledge and the production of technological products by innovative start-ups. To do this, it gives the characteristics of the above-mentioned institutional environments, as well as patterns of behavior in them that do not have the character of formal or informal institutions. Particular attention is paid to psychological traits of entrepreneurs and their cognitive abilities, which may not be available to teachers and researchers at universities and research organizations. Comparison of the content of these environments gives grounds for distinguishing two types of institutional barriers: the first one is of a general economic nature and can generate significant costs for the work of innovative start-ups; the second one is intra-organizational in nature and can generate high risks of transition from science to commercial industry, preventing researchers and teachers from making decisions about creating innovative technology start-ups. The paper concludes with recommendations to reduce the level of barriers of the second type. In particular, to compensate for the risks associated with possible consequences of failure to create a startup and the difficulties of returning to the field of research activity, university management could legally guarantee a teacher or researcher a return to work in scientific or educational departments of faculties for at least five years after creating a startup.

Institutional arrangements of government and municipal response to the COVID-19 pandemic

This study proposes a research strategy that treats a government form as a specific arrangement of institutional features and conducts the study of government form at the institutional-feature level. Consistently, it examines how the three core features of a government – CEO (chief executive officer) selection by appointment based on managerial expertise, mayoral election by the council among themselves, and at-large council election – affect municipal COVID response, a highly politicized area. These features are theorized to reduce the intensity of politics and create space for the effective working of public administration, and hypothesized to be positively associated with active COVID response. The hypotheses are confirmed on the whole from the analysis of original survey data gathered during the pandemic from municipalities in eleven western U.S. states. The implications of the findings for the council-manager form of government are discussed.

Thoughts on Children's Education from the Perspective of Ibn Hajar Al-Haitami

According to Ibn Hajar al-Haitami, the purpose of children's education involves efforts to care, develop, and exploit the potential of students so that they are able to understand kitabulloh, have noble morals, and have the skills to lead an independent life. In order to achieve these educational goals, Ibn Hajar al-Haitami wrote a book that specifically discusses various aspects, including educational objectives, educational flow, educator competencies, children's educational techniques, education costs, and characteristics of children's educational institutions. All these components are analyzed and described in his work entitled Tahrīru al-Maqōl Fī Adābi Wa Ahkāmi Wa Fawā'idu Yahtāju Ilaihā Muˋaddibū al-Aṭfāl. The study focused on six aspects of education discussed in the book, using. Descriptive Content Analysis Method, Types of Literature Research, and Descriptive Qualitative Approach. The main data are obtained from Tahrīru al-Maqōl Fī Adābi Wa Ahkāmi Wa Fawā'idu Yahtāju Ilaihā Muˋaddibū al-Aṭfāl, while the secondary data comes from various books discussing the biography of Ibn Hajar al-Haitami. The research process involves three stages: data collection, data processing, and data reporting. The results showed that the focus of children's educational goals emphasizes the development of material and non-material potential of learners. A religious-conservative approach is used in the flow of children's education, with the dominant educational technique being takzir. The competence of educators that is prioritized includes personal and social dimensions, while education financing can be obtained through salaries, endowments, and grants. Ibn Hajar al-Haitami recommended educational institutions in the form of maktab and madrasa.

Assessment of Dar es Salaam's resilience to climate change disasters using the Climate Disaster Resilience Index (CDRI)

Climate change is becoming an increasingly significant issue in Africa, and the need for climate resilience assessment has intensified. Dar es Salam is one of Africa's emerging megacities. With a population of over seven million, which continues to grow, there is an urgent need to understand the city's ability to deal with natural disasters. The Climate Disaster Resilience Index (CDRI) was used in this study to assess the city's ability to withstand and cope with climatic hazards. The Index was quantified using sets of dimensions (social, physical, economic, natural, and institutional), with various parameters indicating the city's abilities, strengths, and vulnerabilities to potential climate‐related disasters. Despite being moderately resilient to climate change disasters, the results of our study indicate that the city's economic and institutional features obtained the lowest scores and the least resilience level. The study's findings provide a perspective on aspects of the city management sectors in terms of resilience and which should be given greater consideration in order to strengthen the city's current and future resilience.

Exploring carbon emission accounting methods for typical public institutions: a case study of hospitals

Typical public institutions such as government offices, hospitals, and schools play important leading and exemplary roles in the green and low-carbon development of the whole society. This paper analyzes the business and energy consumption characteristics of public institutions, as well as the characteristics of personnel travel, and constructs a carbon accounting model for public institutions. It innovatively proposes a methodology for carbon accounting of personnel travel related to public institutions and validates and analyzes it using a comprehensive hospital as an example. The paper analyzes the carbon emission characteristics of various energy types, systems, and types of travelers in hospitals, provides schemes for the transformation of main energy systems, and corresponding emission reduction effects, thereby providing technical support for the full-chain carbon accounting of public institutions. Additionally, this paper explores the carbon reduction pathways for hospitals to support the peak carbon and carbon neutrality goals of public institutions, and promote the high-quality development of public institutions in China.

Improving Women’s Representation in Politics through Gender Quotas

Gender quotas for women in local government bodies can improve women’s representation in politics, increase provision of public services, and improve perceptions of women as leaders. Gender quotas are one policy tool designed to increase women’s representation in politics. Women hold fewer than 25 percent of parliamentary seats worldwide, and just 12 percent of the world’s heads of state and government are women. In many countries this imbalance extends to local governments. Countries are taking action In 2013, 118 countries were implementing a form of gender quotas for an elected office. Women's empowerment and their full participation on the basis of equality in all spheres of society, including participation in the decision making process and access to power ,are fund a mental for the achievement to fequality , development and peace. One way to implement gender quotas is by reserving a certain number of leadership positions for women. A review of eleven randomized evaluations in India, Lesotho, and across 28 states in India found that reservation quotas influenced women’s political participation and policy outcomes and increased the provision of public goods aligned with female voters’ preferences. Further, quotas improved men’s perceptions of women as leaders, increased the aspirations of girls, and helped women get elected even after quotas were removed. Most of the rigorous research drawn on in this insight comes from India comparative conclusions should be drawn cautiously. This evidence largely suggests that governments seeking to improve women’s representation in politics should consider reservation quotas for local leadership positions. overview of the three main types of quota policies reserved seats, party quotas, and legislative quotas. These are found in all major world regions in countries with a broad range of institutional, social, economic, and cultural characteristics. At the same time, the mere advent of gender quotas has not resulted in uniform increases in the percentage of women in parliament worldwide some countries have witnessed dramatic increases, while others have seen more modest changes or even setbacks in the number of women elected to national assemblies. Despite the rapid international diffusion of these measures, most research has focused on single countries or, at most, the presence of quotas within one world region. Consequently, explanations for the adoption and impact of gender quotas derived from one study often contradict .

How Does Low-Carbon Financial Policy Affect Corporate Green Innovation?—Re-Examination of Institutional Characteristics, Influence Mechanisms, and Local Government Behavior

This paper employs a propensity score matching approach to construct a control group and estimate the impact of the CETS pilot policy, a low-carbon financial policy, on corporate green innovation and its impact mechanism in a difference-in-difference manner. The results show that the CETS pilot policy has a significantly positive effect on corporate green innovation. The higher the penalty degree and the carbon price, the more obvious the promotion of the green innovation of pilot enterprises. The mechanism test shows that the improvement of corporate green innovation is mainly due to the incentive effect rather than the anti-driving effect of the CETS pilot policy, that is, the policy promotes corporate green innovation by providing innovation resources and enhancing the willingness to innovate. Further analysis shows that only in regions where local governments have less competitive pressure can the CETS pilot policy effectively promote enterprise innovation resources and that a close and clean government–business relationship can help strengthen the promotion effect of the CETS pilot policy on the willingness of enterprises to innovate. Furthermore, this paper introduces its theoretical framework as a strategic tripod to explore the friction in the process of the CETS pilot policy affecting corporate green innovation from the perspective of the industry environment and corporate resources. This research shows that a lack of industry green technology and corporate human capital may hinder the positive impact of the CETS pilot policy on corporate green innovation. Finally, this study found that the CETS pilot policy has no significant impact on the quality of corporate green innovation, and the lack of industry green technology and corporate human capital may hinder the CETS pilot policy from improving the quality of corporate green innovation.

STRESS AND HEALTH BEHAVIOR OF HEALTH PROFESSIONS STUDENTS IN BULGARIA

The purpose of this study is to determine the prevalence of stress among students of various health specialties in Bulgaria and to examine its relationship with the individual and institutional characteristics of the students and with their health behavior. Methods: A survey was conducted among students from all 26 Bachelor and Master of health sciences programmes at a Medical University in Bulgaria. Information on self-assessed levels of health and stress, aspects of the health behavior (physical activity, smoking, alcohol intake, diet and sleep duration), personal (age, gender) and institutional factors (specialty and year of study) was collected with a structured questionnaire. Multinomial logistic regression was performed to evaluate the determinants of the perceived high level of stress. Results: A total of 570 (10% sample) of all students from the university with a mean age of 24 (SD 7.6) years took part in the study. The majority of students (61.7%) experienced a moderate level of stress. Self-reported high level of stress (25.4%) was significantly independently associated with three factors - female gender (OR=2.92, 95% CI=1.09-7.81), low level of self-rated health (OR=6.95, 95% CI=2.17-22.25) and higher (fourth or fifth) year of study compared to first (OR=5.49, 95% CI=1.72-17.59; OR=4.06, 95% CI=1.36-12.16). Conclusions: Stress is an important problem affecting the health of this group of the population. Active actions for building environments conducive to and supporting students' mental health are necessary, for which medical universities are in a very favourable position.